05.12.2014

#FullRepeal Daily Digest

Forbes: New McKinsey Survey: 74% Of Obamacare Sign-Ups Were Previously Insured

The new McKinsey report…indicates that the proportion of uninsured individuals paying for coverage has shot up, from 53 percent in February to 83 percent in April. For previously insured individuals, the percentage of payers increased from 86 to 89 percent.
The proportion of individuals purchasing ACA plans who had been previously uninsured remained low. In February, McKinsey reported that only 27 percent of those selecting a new 2014 plan were previously uninsured; in April, the proportion was 26 percent.
Combining that with the payment figures: of the people signing up for new ACA plans in 2014, only 22 percent were previously uninsured individuals who have paid for coverage and therefore enrolled in health insurance. That’s a meaningful improvement from February’s 14 percent figure, but it’s still low.
Combining all of this data: of the 8 million sign-ups on the exchange, we can only be confident that around 1.7 million are previously uninsured and enrolled. We can add another 865,000 or so for those purchasing coverage off the exchange, for a total of 2.6 million previously uninsured individual-market enrollees.

Politico Pro: $474M for 4 failed Obamacare exchanges

Each of the states — Massachusetts, Oregon, Nevada and Maryland — embraced Obamacare, and each underperformed. All have come under scathing criticism and now face months of uncertainty as they rush to rebuild their systems or transition to the federal exchange.
The $474 million spent by these four states includes the cost that officials have publicly detailed to date. It climbs further if states like Minnesota and Hawaii, which have suffered similarly dysfunctional exchanges, are added. Their totals are just a fraction of the $4.698 billion that the nonpartisan Kaiser Family Foundation calculates the federal government has approved for states since 2011 to help them determine whether to create their own exchanges and to assist in doing so. Still, the amount of money that now appears wasted is prompting calls for far greater accountability.

Weekly Standard: Obamacare Myth-Making Five Phony Success Stories

First, they say that premium rates are down. In support of this, liberals cite research from the Congressional Budget Office (CBO), but they misinterpret it. In fact, the CBO’s most recent estimate of premiums shows a decline not from what they were in 2013, before the implementation of Obamacare, but rather from what CBO estimated they would be in 2014. Studies from many outlets have shown that rates have gone up since 2013, substantially for many people.
Second, supporters claim that Obamacare exceeded the enrollment target promulgated by the CBO. This is questionable. The CBO last year projected 7 million enrollees, and the Obama administration now gloats that 8 million people selected a plan in the exchanges. But not everybody who selected a plan will pay for it. The best estimate right now is that about 15 percent of initial enrollees are not paying their first premiums. If that holds, paid enrollment will come in slightly under CBO’s 2013 prediction. But there is more. CBO downgraded its forecast earlier this year from 7 million to 6 million, and this month declined to update it even after the “surge” of last-minute enrollees began. The reason: The prediction is an annual average. By this metric, Obamacare will struggle to hit 6 million, with enrollment so weak in the first quarter.
Third, liberals claim that insurers are happy, pointing to recent earnings reports from the biggest companies. But this is a non sequitur. The insurers have become clients of government. Federal subsidies to exchange insurers this year will hit approximately $10 billion, thanks to a program called “reinsurance” that reimburses Obamacare exchange enrollees for excessive claims. As a point of reference, $10 billion just about equals the combined profits of the top five insurers in 2013. Moreover, the total subsidy could go even higher, thanks to another feature of Obamacare known as “risk corridors.” Insurers on the exchanges are enjoying private profits and socialized losses. Who wouldn’t be happy? What will really matter is how insurers feel in 2017, when reinsurance and risk corridors expire and the exchanges must stand on their own.
Fourth, liberals claim the law is “working.” This omits the dozens of provisions that the president has suspended or delayed because they were not working—for budgetary or political reasons. The suspended
or postponed provisions include the mandate that businesses cover full-time employees, the cancellation of noncompliant plans, and cuts to Medicare Advantage…To say the law is working is like saying you “ate your dinner” when you gulped down your dessert and skipped the veggies. Just as your mother said you could not have one without the other, so the popular provisions of Obamacare are linked to the unpopular ones. Sooner or later, the administration will have to enforce the law—or watch a vast array of unintended side effects disrupt the national health care system.
Fifth, the left assures us Obamacare cannot be repealed. This is particularly rich, considering all the provisions the administration itself has effectively repealed when it found them inconvenient.

Politico: Why Both Sides Are Losing the Health Care Debate

In a word, the solution to America’s health care woes is innovation — the cost-cutting innovation we’ve seen in almost every other industry. Genomics, 3-D printing, nanobots, wearable sensors, social media, telecommunications, imaging, artificial intelligence, state-of-the-art data mining and other new technologies are poised to deliver health and healing and lifesaving in ways that were inconceivable just a few years ago. The ACA will impede innovation by, among other things, homogenizing the delivery of care and funneling resources toward well-entrenched providers. But the same is true of a maze of state and federal laws, regulations, institutions and customs that long predate the ACA.
To seize the offensive, ACA opponents will have to define a new vision, based on innovation. To do so, they will have to cross swords with hospitals, physician groups, academicians, attorneys, medical schools, state governments, federal agencies and more. If they are not willing, medicine’s ability to reduce suffering and contain costs will be far below its potential. If they are willing, they might find some unconventional allies in surprising places.

Breitbart: CA Obamacare Patients Driving To Tijuana, Mexico for Cheaper, Faster Care

The Obama administration has lamented the fact that Latino Obamacare enrollments remain surprisingly low. However, according to USA Today, "Mexican immigrants living in California, Arizona, Texas and New Mexico have long sought health care in border cities such as Tijuana, Mexicali and Nogales. The Affordable Care Act won't change that, experts said."
Center for the Study of Latino Health and Culture at the UCLA School of Medicine Director David Hayes-Bautista said high U.S. costs and low access may mean that "it's possible even more U.S. residents may seek care with Mexican doctors."

NCPA: Obamacare Will More than Double Profit Margins for Hospitals' Emergency Departments

[A new study estimates that] hospital revenue from ED care exceeded costs for that care by $6.1 billion in 2009, representing a profit margin of 7.8 percent (net revenue expressed as a percentage of total revenue). However, this is primarily because hospitals make enough profit on the privately insured ($17 billion) to cover underpayment from all other payer groups, such as Medicare, Medicaid, and unreimbursed care. Assuming current payer reimbursement rates, ACA reforms could result in an additional 4.4-percentage-point increase in profit margins for hospital-based EDs compared to what could be the case without the reforms.