Baldo

Jun 3 2015, 07:23 PM

White House Begins to Bully the Supreme Court Again

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http://www.nytimes.com/aponline/2015/06/03/us/politics/ap-us-supreme-court-health-overhaul.html

How Do Justices Weigh Loss of Health Insurance for Millions?

The Supreme Court could wipe away health insurance for millions of Americans when it resolves the latest legal fight over President Barack Obama's health overhaul. But would the court take away a benefit from so many people? Should the justices even consider such consequences?

By month's end, the court is expected to decide a challenge to the way subsidies are given to people who get their health insurance through the Affordable Care Act. The issue is whether Congress authorized the payment of the subsidies to people regardless of where they live, or only to residents of states that established their own health insurance exchanges.

The distinction is potentially momentous because more than two-thirds of the states did not set up their own exchanges.

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http://www.washingtonexaminer.com/article/2565599

Burwell warns of 'death spiral' if Supreme Court rules against Obamacare

..."We believe we hold the right position," Burwell said. "We believe we're implementing the law as it was written."

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Burwell warns of 'death spiral' if Supreme Court rules against Obamacare

Baldo

Jun 3 2015, 07:23 PM

White House Begins to Bully the Supreme Court Again

In an echo of the last time the Supreme Court held the fate of the Affordable Care Act in its hands, the White House today began warning the Court of the kind of rhetoric it would face if it eviscerates the crown jewel of President Obama’s presidency.

White House Press Secretary Josh Earnest today suggested that the Court would be responsible for wrecking the U.S. health care system by undermining Obamacare should it take the side of Plaintiffs in the King v. Burwell case, a decision to be handed down this month that would invalidate the federal Obamacare health insurance exchanges used by 37 states.

Earnest said:

If the Supreme Court were to throw the health care system in this country into utter chaos, there would be no easy solution for solving that problem because it would likely require an act of Congress in order to address that situation.

Note the careful phrasing here. Earnest is laying culpability on the Supreme Court, when all the Court would be doing is to decide that Congress failed to provide subsidies for federally-created exchanges, as opposed to those created by the state.

The tactic harkens back to April 2012, when Obama indicated he would attack the Court if it failed to uphold Obamacare during a challenge to the law that year:

Ultimately, I’m confident that the Supreme Court will not take what would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress.

In fact, CBS News later reported that Chief Justice John Roberts did change his opinion, allowing the law to survive by a 5-4 majority, and that he was concerned about damage to the Court...snipped

http://www.whitehousedossier.com/2015/06/03/white-house-begins-bully-supreme-court/


Let's see what that wimp Roberts does this time?

Baldo

Jun 4 2015, 03:10 PM

No, New York Times, “guesswork” is not the reason ACA premiums are rising

The New York Times, whose editorial board has long been a strong supporter of the Affordable Care Act, published an article on its front page yesterday in which the headline read, “Seeking Rate Increases, Insurers Use Guesswork.” And, lest there be much doubt that the article suggested that speculation — the sort that regulators might understandably reject as a basis for premium hikes — rather than hard facts were leading to the frightening premium hikes, here are some quotes selected by author Reed Abelson for publication:

“But many insurers, including those seeking relatively hefty increases below 10 percent, say they are asking for higher premiums because they remain unsure about the future and what their medical costs will be.”

“It’s the year of actuarial uncertainty, and actuaries are conservative,” said Dr. Martin Hickey, chairman of the National Alliance of State Health CO-OPs and the chief executive of the New Mexico exchange. “The safest thing to do is to raise rates.”

Yes, to be sure, there was the suggestion in other parts of the article that higher than expected claims were part of the problem, but both the headline and remaining comments suggest that the high rates of increase were the result of unsupported speculation.

Wrong, New York Times! If you actually read the justifications for the premium increases submitted by insurers and their accompanying actuarial memoranda, you can see there are two dominant themes: (1) higher than expected claims expenses and (2) diminution of federal subsidies to the insurance industry. You can also see lengthy memoranda containing facts and figures explaining their experience last year and the basis for their trending those experiences into the future. And, while one need not invariably take the insurance industry at its word or at face value, this is an instance where they have to make the best case possible for their rate increases. Regulators will scrutinize insurers’ work. Misstatements or rank guessing would seem to be against the insurance industry’s interest.

So instead of quoting people, who might themselves be guessing, let’s look at what the insurers actually said. I am going to bore you with 17 representative filings from across the nation. I do so because I want to make clear that the evidence is overwhelming. Most of these are contained in or accompanied by lengthy memoranda containing elaborate tables justifying the increases. I’ve attempted to be diverse in my selection of insurers to avoid repetition of, for example, the Blue Cross position or the Aetna position....snipped

......

Conclusion

So, does this sound like “guesswork” to you? It does not to me. All of these insurers are lying or mistaken about what is causing their requests for premium hikes? I don’t think so. Of course, there is “trending” in which insurers approximate how previous increases will continue to the future and this requires some art on the part of insurers. Of course, insurers may want to present their requests for rate hikes in a way more likely to be approved. But what they have presented is no more “guesswork” here than the work of any insurer in setting rates for almost any form of insurance. It is the sort of actuarial projections that are generally approved by regulators.

Health insurers now have a decent feel what it is going to cost them to participate in Obamacare. And these insurers have a pretty common perspective: the whopping increase are driven by greater utilization than expected among those electing coverage (adverse selection and moral hazard), increases in the cost of medicine, and reduction of federal subsidies.

Exactly what some people predicted.

http://acadeathspiral.org/2015/06/02/no-new-york-times-guesswork-is-not-the-reason-aca-premiums-are-rising/

But Obama, Reid, & Pelosi said it was going to lower healthcare costs!

BTW you can read the explanation of the 17 representative filings, but I doubt anyone in Congress reads anything.

Baldo

Jun 4 2015, 03:10 PM

No, New York Times, “guesswork” is not the reason ACA premiums are rising
snip

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http://khn.org/news/new-preventive-health-services-approved-for-no-cost-coverage/

New Preventive Health Services Approved For No-Cost Coverage

The list continued to grow of preventive services that people are entitled to receive without paying anything out of pocket.

In 2014, the U.S. Preventive Services Task Force recommended two new services and tweaked a handful of others that had previously been recommended. Under the health law, preventive care that receives an “A” or “B” recommendation by the nonpartisan group of medical experts must be covered by health plans without charging consumers. Only grandfathered plans are exempt from the requirement.

The new recommended services are: Hepatitis B screening for adolescents and adults at high risk for infection, and low-dose aspirin use for pregnant women who are at high risk for preeclampsia, a condition characterized by an abrupt increase in blood pressure that can lead to serious complications for the woman and baby.

In its Hepatitis B screening recommendation, the task force said there was new evidence that antiviral treatments improved outcomes in people at high risk for the liver infection, including those from countries where the infection is common, people who are HIV-positive and injection drug users.

[...]

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http://www.usatoday.com/story/news/nation/2015/06/04/council-economic-advisers-medicaid-expansion-effects/28463111/

White House: Medicaid expansion would save billions, 5,200 lives

Hospitals' non-reimbursed costs for treating patients would be $4.5 billion lower next year if Medicaid coverage was expanded to the poorest residents in states that haven't done so, according to a new White House report out Thursday.

The 28 states that have already expanded Medicaid -- the polarizing healthcare program for the poor and disabled -- are on track to reduce these uncompensated care costs by almost the same amount, an estimated $4.4 billion in 2016, the White House Council of Economic Advisers said.

If states don't expand Medicaid, people with private insurance pay more for their health care and insurance, and their tax dollars go to help pay for the non-reimbursed costs of the uninsured. The expansion of Medicaid, the report concludes, improves the standard of living of a state's residents.

Medicaid is a state- and federally-funded program, but the federal government is covering the full cost of the expansion of the program, bringing coverage to singles making less than about $16,000 a year and families of four earning no more than $32,500. These people can't buy subsidized insurance on the Obamacare exchanges, and a Supreme Court decision left it up to states to decide whether or not to expand Medicaid to cover all of them.

Starting in 2017, states would have to pick up a small portion of the cost of this Medicaid expansion, and that portion would grow to 10% by 2020.

Many Republicans and others have expressed concerns about the costs to states and the federal government of expanding Medicaid. Justin Owen, president of the Beacon Center of Tennessee, a state that has not expanded Medicaid, says expanding the program is harmful for taxpayers and threatens to exacerbate doctor shortages and stymie access to care.

"We see Medicaid expansion as one of the worst aspects of Obamacare," he says.

The White House report compiled evidence of the benefits of Medicaid expansion culled from economics and health policy literature. It acknowledges that "estimates of the effects of future policy changes based on past experience are necessarily uncertain" but notes, "this evidence leaves no doubt that the consequences of states' decisions are far-reaching, with major implications for the health of their citizens and their economies."

Among the benefits, it says, is better access to health care for low-income residents. The report estimates that if all states that have not yet expanded Medicaid did so, 626,000 more people would get their cholesterol checked each year once the expanded coverage was in effect. This improved access to care would prevent 5,200 deaths every year. States that have already expanded Medicaid will avoid an estimated 5,000 deaths per year.

Medicaid expansion remains a contentious issue even in places where it has been touted as a success.

In Kentucky, which has gained national prominence as the only southern state to fully embrace Obamacare, two recent reports gave conflicting pictures of how Medicaid expansion has affected the state. A February report from Deloitte Consulting and the University of Louisville's Urban Studies Institute said Kentucky hospitals received $506 million more in Medicaid reimbursement since January 2014 because of the expansion and that the expansion generated more than 12,000 new jobs in health care and related fields.

But a report last month by the Kentucky Hospital Association said Obamacare overall has left them facing billions of dollars in cuts and forced them to lay off staff and shut down services. Most of the newly-insured in the relatively poor state enrolled in Medicaid, which hospital officials said now pays 82% of the actual cost of treating patients. So even though hospitals are getting $506 million more in Medicaid payments, officials said, it costs $617 to provide care to those patients.

The number of people with coverage through Medicaid or the Children's Health Insurance Program (CHIP) increased 2.2 million people from the start of the first open enrollment period under Obamacare through March 2015. From February to March alone, the number of people with Medicaid or CHIP coverage rose by more than 500,000 people.

kbp

Jun 5 2015, 09:46 AM

“I think it is an evolving picture,” she said. She also said the coverage gains would be checked, in part, by the law’s exclusions on unauthorized immigrants.

“There are people in our country who probably won’t end up in the system without solutions to immigration issues,” she said.

[...]

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http://www.cnsnews.com/news/article/eric-scheiner/nearly-half-us-cant-afford-unexpected-400-bill-forgo-medical-treatment

Nearly Half of U.S. Can’t Afford Unexpected $400 Bill – Forgo Medical Treatment




Nearly half of American households would not be able to afford a $400 emergency, according to a recent report from the Federal Reserve.

The Federal Reserve Report on the Economic Well-Being of U.S. Households in 2014 says that 47 percent indicate that they would have great difficulty handling an unexpected $400 expense.

“Specifically, respondents indicate that they simply could not cover the expense (14 percent); would sell something (10 percent); or would rely on one or more means of borrowing to pay for at least part of the expense, including paying with a credit card that they pay off over time (18 percent), borrowing from friends or family (13 percent), or using a payday loan (2 percent),” the report says.

Even though it has been over 5 years since President Barack Obama signed the Affordable Care Act into law, 47 percent of Americans responding to the Federal Reserve study claimed that they “avoided medical treatment because of the cost.”

[...]