Obamacare News of the Day

Washington Post: Administration will allow people to switch health-care plans to a limited degree

• The Obama administration has quietly reworked rules and computer code for HealthCare.gov to try to stem an outpouring of discontent by some Americans who have discovered that the health plans they bought do not include their old doctors or allow them to add new babies or spouses.Under changes that have not been disclosed to the public, the government will temporarily allow consumers who have gotten coverage through the new online insurance marketplace to switch health plans to a limited degree.
• In a memo distributed Thursday night to insurers, federal health officials said that people may pick a different health plan before the end of March if they are dissatisfied with the one they chose, but only if they stay with the same insurer and generally the same level of coverage. The 14-page memo, obtained by The Washington Post, also says people will be given more freedom and a longer opportunity to get a new health plan if they can prove that HealthCare.gov, the Web site for the new marketplace, displayed inaccurate information about the benefits that a health plan offers.

Wall Street Journal: Millions Trapped in Health-Law Coverage Gap Earning Too Little for Health-Law Subsidies but Ineligible for Benefits Under Existing Medicaid Programs [The solution isn't to expand a broken Medicaid system or Obamacare subsidies, but to provide all Americans an opportunity to control their own health care dollars and purchase an affordable, personal plan they can own for the rest of their lives]

• Like millions of other Americans caught in a mismatch of state and federal rules, the 57-year-old hair stylist doesn't make enough money to qualify for federal subsidies to buy health insurance. If he earned another $1,300 a year, the government would pay the full cost. Instead, coverage would cost about what he earns.

USA Today: For 3 million, 'affordable' health care might not be For millions, subsidies don't kick in until 9.5% of their income goes to premiums

• The promise comes with a catch for almost 3 million people earning three to four times the federal poverty rate: They may have to pay up to 9.5% of their income toward that premium before the government subsidy kicks in. That could take a substantial bite from their budgets — potentially as much as $600 a month for a family of three earning $58,590 to $78,120. As a result, some middle-class families may decide health insurance is beyond their reach and pay a penalty rather than buy coverage.

Los Angeles Times: California health exchange pulls error-ridden physician list —again

• Admitting it gave some consumers bad information, California's health insurance exchange pulled its physician directory for having too many errors.
• Covered California made the move late Thursday amid growing frustration among both consumers and doctors over inaccurate information about insurance networks in the state marketplace.  The exchange yanked its online directory of medical providers in mid-October after acknowledging there were serious problems then with the data. It published an updated list in November.

Los Angeles Times: Corporate backing is helping Obamacare go mainstream [Big businesses embrace Obamacare while their customers suffer its consequences with less income, more expensive health plans and fewer choices]

• Fans of the Jet City Rollergirls are hearing public announcements about Obamacare when they go to the roller derby track north of Seattle.
• Univision, the nation's largest Spanish-language television network, is airing half-hour specials about healthy living and educating viewers about how to sign up for coverage under President Obama's health law.
•  And tax preparers at thousands of Jackson Hewitt and H&R Block offices are talking to their customers about how to enroll in the new insurance plans sold through the law's online marketplaces.
• "Once the legislation became the law of the land, we feel it became a reasonable decision to educate our fans as to how it impacts their lives," said Brad Ruiter, a spokesman for the Minnesota Timberwolves. The National Basketball Assn. franchise is running ads at home games paid for by the state's insurance marketplace.

The Boston Globe: Republicans debate mini-bailouts for hospitals [Recall that the national hospital lobby aggressively supported Obamacare. The Faustian bargain they struck was a reduction in their bonuses for uncompensated care in exchange for the purported millions of newly insured Americans entering the system. As Obamacare's failures become more apparent, hospitals and lawmakers are finding new ways to divert taxpayer dollars back to hospitals.]

• Now Republican leaders in Georgia and Mississippi may be bailing out hospitals that will lose funding they would have gotten from Obama’s health care law. South Carolina’s leaders increased payments to some hospitals in a push to improve rural health, though the extra money likely placated hospital officials who might otherwise have pressured Republicans to adopt the Democratic plan.

Modern Healthcare: Budget model uncertain for state health exchanges

• The 14 states running their own health insurance marketplaces had all their startup costs footed by the federal government, but they're supposed to pay for themselves starting next year under the federal healthcare reform law. In several states, it's not clear whether it will work out that way. Projected enrollments are lower than expected, meaning the insurance surcharges designed to sustain the exchanges might not generate enough revenue in the years ahead without significant changes in the financing model.
• Officials in some states are stashing away federal grant money to continue paying for operations beyond the January 2015 target date for financial self-sufficiency. Others are contemplating staffing cuts or boosting insurance surcharges.To date, the 14 states operating their own exchanges, plus the District of Columbia, have received nearly $3.8 billion to start and operate their health insurance exchanges, according to a state-by-state tally by The Associated Press.

The Federalist: Obamacare Destroys Jobs, No Matter How Hard The Left Tries To Deflect Criticism

• When the Congressional Budget Office published a report last week that the economy would have 2.5 million fewer jobs under Obamacare by 2024, its defenders resorted to redefining commonly used terms to deflect criticism.Politifact found a sudden distinction between the number of jobs and the number of workers. How? By redefining “jobs” to mean positions created by employers. But the normal usage of job – in journalism and academia – is to refer to a match between a worker and a position. Likewise, the phrase “job destruction” is a standard way academics refer to the end of such a match, whether initiated by the worker or the firm.
• Americans Against the Tea Party had the biggest laugher, “This is good news, as it makes an expected 2.3 million jobs available to the millions of people still looking for work.” That would be nice, but it’s a wish totally unsupported by CBO’s results. If supply shrinks and demand stays constant, quantity falls. Their implicit assumption is that labor demanded is the same at all wage rates; empirical research shows that is far from the truth.

Bloomberg: Jails Enroll Inmates in Obamacare to Pass Hospital Costs to U.S.

• Being arrested in Chicago for, say, drug possession or assault gets you sent to the Cook County Jail to be fingerprinted, photographed and X-rayed. You’ll also get help applying for health insurance.
• At least six states and counties from Maryland to Oregon’s Multnomah are getting inmates coverage under Obamacare and its expansion of Medicaid, the federal and state health-care program for the poor. The fledgling movement would shift to the federal government some of the more than $6.5 billion in annual state costs for treating prisoners.

Health Care Policy and Marketplace Review: Is Obamacare Unraveling?

• …the law's reinsurance provisions will mean Obamacare can keep limping along for at least three years. And, even making this change [extending the individual policies that Obamacare canceled for up to three years] won't alter my opinion on this. It will just cost the government more reinsurance money to keep the carriers whole.
• By asking if it is unraveling, what I really wonder about is the whole sense of fairness in the law and the expectation that everybody needs to get the Democrat's definition of "minimum benefits" whether they want them or not. Obamacare has created a well-documented market that is heavy in mandated minimum benefits but also as a result impacted by big deductibles, narrower provider networks, and higher premiums.
• Those people in pre-Obamacare individual market policies don't have the big benefit mandates but they generally also have smaller deductibles, wider networks, and lower premiums.
• And, what about the much larger small employer market that is now being forced into the same Obamacare mandates often resulting in much higher premiums and deductibles? Do they get a reprieve––many of them have also deferred their compliance by using the carriers' early renewal programs? Would it be fair to make almost indefinite a two-tiered health insurance system with some people being able to keep their old policies but prevent others from getting them?
• This might be one of those you can't win for los'in moments for the administration. Stay on the cancellation track and make lots of people mad one more time on election-day or grant another three-year reprieve and make the people you forced to buy the new plan wonder why they can't have the policy their neighbor across the street has.
• Last fall I said that I thought it would be late January or early February before Healthcare.gov would generally be fixed. Boy, was I wrong.The to-do list still includes:
  • Problems with the government sending enrollment transactions to the carriers––the 834s––that are still having error rates much too high for high volume processing.
  • The inability of the government to do an automated enrollment reconciliation with the carriers––to be able to sort out who really is covered and who is not––because that system still hasn't been built.
  • The inability of the government to pay carriers because that system hasn't been built––carriers are sending estimated bills to the feds.
  • The inability of the government to add and delete people from the system for things like a newborn or a divorce because that system hasn't been built yet.
  • The inability of the government to handle appeals when people think their eligibility or subsidy calculation is wrong because that system hasn't been built yet.
  • The inability of the government to cancel people off of Healthcare.gov because they never built that functionality. As a result, I expect they will be reporting bloated enrollment numbers for some time.

[Chart] The Advisory Board Company: Health care sector saw slowest jobs growth since 1999 [note: Obamacare is not among the author's primary factors cited for the slow jobs growth. The consolidation in health care – one of the factors cited – is arguably exacerbated by Obamacare, in particular the Accountable Care Organization model. The chart does however, along with the most recent CBO report, conflict with Rep. Nancy Pelosi's statement that Obamacare is "about jobs. In it’s life, it [the health bill] will create 4 million jobs — 400,000 jobs almost immediately.”]