Patient Power Now

Colorado Health Benefit Exchange: bare-bones and expensive plans

Posted on March 11, 2013 by Brian Schwartz

At Real Clear Markets, Scott Gottlieb writes:

There’s mounting evidence that come fall, the health plans sold through the Obamacare exchanges will be bare bones affairs – with narrow networks of providers to select from, and heavy co-insurance once patients go “out of network.” …

Health plans have ample incentives to price the Obamacare coverage high, which is precisely what they’re likely to do. …

For one thing, insurers will want to protect against the risk that individuals entering the exchanges are those who most need health insurance because of pre-existing illness. …

Second, health plans want to reduce uncertainty around how all the risk-sharing provisions in Obamacare will eventually play out. …

Third, health insurers will want to reduce the incentive for employers to drop coverage and dump employees into the exchanges. …

Finally, the providers that Obamacare plans must contract with are unlikely to offer significant price cuts to attract this volume.

The Colorado exchange will soon be called “Connect for Health Colorado.”

Via the NCPA.

Arkansas Deal with HHS on Medicaid Expansion a Model for Colorado

Posted on March 4, 2013 by Brian Schwartz

At Complete Colorado, Linda Gorman of the Independent Institute writes:

Health and Human Services has agreed that Arkansas can pay premiums for commercial insurance purchased through the state’s health insurance exchange using the federal funding that would have gone to expand Medicaid. …

For those who are not disabled, commercial insurance is more flexible than Medicaid and offers better access to health care. Medicaid reimbursement for specialist care lies far below commercial reimbursement amounts. People with Medicaid coverage often also have a difficult time accessing specialists. …

The possibility of a deal with Health and Human Services gives Colorado officials a rare chance to improve the medical care available to low-income people by shaking off the shackles of Medicaid.

See also: “Arkansas’s unusual plan to expand Medicaid,” in the Washington Post.

Twelve Reasons Colorado should say no to Medicaid expansion

Posted on February 26, 2013 by Brian Schwartz

Avik Roy & Grace-Marie Turner in National Review present 12 reasons Virginia, or any state (like Colorado), should not expand Medicaid:

Virginia’s Medicaid spending will explode
Medicaid harms the poor.
Medicaid’s access problems will get worse as more doctors drop out.
Claims about job creation are exaggerated.
Claims about coverage expansion are exaggerated.
Medicaid raises premiums for those with private insurance.
Medicaid’s undercompensated care is a bigger problem than providing uncompensated care for the uninsured.
Expanding Medicaid will expose [states] to immense amounts of fraud and waste.
[States] will be exposed to higher Medicaid costs when Washington recalculates its matching payments.
By rejecting the Medicaid expansion, Virginia encourages other states to do the same, reducing waste of taxpayer dollars.
Medicaid will worsen the cycle of dependence and harm the economy.
Exchanges will provide better health outcomes, far less fraud, and fiscal certainty.

Read details on each: Twelve Reasons to Say No – National Review Online.

For more on Medicaid expansion, see posts on Colorado Medicaid.

LA Times: “States worry about rate shock during shift to new health law “

Posted on February 25, 2013 by Brian Schwartz

The LA Times reports:

Exactly how high the premiums may go won’t be known until later this year. But already, officials in states that support the law have sounded warnings that some people — mostly those who are young and do not receive coverage through their work — may see considerably higher prices than expected.

That is because of new requirements in the law aimed at making insurance more comprehensive and more affordable for older, sicker consumers. …

Oregon’s insurance commissioner, another supporter of the law, said new regulations could push up premiums for young customers by as much as 30% next year. He urged administration officials to slow enactment of the new rules.

via States worry about rate shock during shift to new health law – Los Angeles Times.

In 2010, the AP reported:

Beginning in 2014, most Americans will be required to buy insurance or pay a tax penalty. That’s when premiums for young adults seeking coverage on the individual market would likely climb by 17 percent on average, or roughly $42 a month, according to an analysis of the plan conducted for The Associated Press. The analysis did not factor in tax credits to help offset the increase.

Plan for fighting Obamacare: Delay, Repeal, Replace

Posted on February 18, 2013 by Brian Schwartz

In the Weekly Standard, James C. Capretta and Jeffrey H. Anderson^* write:

Disappointing as [the Supreme Court ruling and presidential election] were, they do not remotely constitute the end of the fight to repeal and replace Obamacare. Indeed, this is a fight conservatives couldn’t walk away from even if they wanted to, because health policy is absolutely central to the struggle over the size and scope of governmental power. If Obamacare remains on the books, the federal government will become the dominant actor in nearly one-fifth of the American economy, tens of millions more Americans will become dependent on taxpayer support for their health care, the quality of American medicine will decline, and the spending commitments in the law will increase the pressure for ever-higher taxes—even as they add to the risk of national insolvency. …

Delaying the implementation of Obamacare would be important for three reasons: It would save hundreds of billions of dollars in federal spending. It would spare Americans from having their health care premiums spike until a somewhat later date. And it would move the onset of Obamacare much closer to the 2016 presidential election, which would put Obama’s centerpiece legislation at center stage in that race—as the future health of the nation demands that it be. …

Beyond resisting and delaying the implementation of Obamacare, the most important thing for the GOP at this point is to develop and unite behind a practical replacement proposal—one that will actually solve the very real problems plaguing American health care. …

If Republicans were to advance a replacement along these lines—a plan that would provide stable insurance options, consumer choice, and high-quality health care without the heavy-handed mandates and regulations of Obamacare—the American people would be more than happy to throw Obamacare overboard.

The key to turning back the singular threat that Obamacare poses to our liberty and fiscal solvency is for the GOP to have a plan of attack that extends across the next four or five years

So the fight must go on. The only question, at this point, is how to proceed.

Read the whole article: Delay, Repeal, Replace | The Weekly Standard.

* James C. Capretta is a senior fellow at the Ethics and Public Policy Center and a visiting fellow at the American Enterprise Institute. Jeffrey H. Anderson is a senior fellow at the Pacific Research Institute

Paul Hsieh, MD: Why Doctors Should Not Ask Their Patients About Guns

Posted on January 23, 2013 by Brian Schwartz

Paul Hsieh, MD in Forbes:

Should doctors ask patients if they own guns? Currently, ObamaCare bans the federal government from using patient medical records to compile a list of gun owners. But following the Newtown, CT shootings, President Obama issued an executive order clarifying that “the Affordable Care Act [ObamaCare] does not prohibit doctors asking their patients about guns in their homes.” The American Academy of Pediatrics (AAP) similarly encourages physicians to ask patients if they own firearms — in the name of protecting child safety. As a physician, I consider this advice misguided. Instead, physicians should not routinely ask patients whether they own guns, because it could compromise the integrity of the doctor-patient relationship. …

University of Chicago economics professor Steven Levitt has also warned about excessive fear mongering about gun ownership. In their best sellerFreakonomics, he and co-author Stephen Dubner note that a child is 100 times more likely to die in a swimming accident than a gun accident.

Yet the AAP does not tell parents to “NEVER bring your child to a swimming pool,” nor does it advocate “the strongest possible regulations of swimming pool ownership.” Rather, it recommends that parents supervise children around swimming pools and follow basic rules of water safety. The AAP correctly recognizes that a home swimming pool can be a genuine value to a family, provided that parents and children follow proper precautions. Similarly, a gun can be a genuine value to responsible homeowners, provided that parents and children follow proper precautions. …

A local colleague, Dr. Matthew Bowdish, has declared, “I will not undermine the Second or Fourth Amendment rights of any of my patients who are lawful gun owners. Nor will I record my patients’ gun ownership status in any medical records that could be accessed by government officials unless relevant to a specific medical issue.” This should be the credo of all freedom-loving physicians.

via Why Doctors Should Not Ask Their Patients About Guns – Forbes.

Reforming Medicaid with “Health Stamps”

Posted on January 22, 2013 by Brian Schwartz

John C. Goodman writes:

The idea behind health stamps is straightforward. Like food, health is generally considered a necessity. So why not treat it the same way we treat food?

We don’t segregate grocery stores into those that sell to poor customers and those that do not. Grocery stores take all comers, and they charge the same price to each of them. … The [food stamp] program allows poverty and near-poverty families to have access to the full range of food products. Because they pay market prices, food stamp families are welcome customers at every grocery outlet. Although they live with more limited budgets, food stamp families are able to make tradeoffs in grocery choices—using food stamps in a way that meets their own preferences and needs. Competition for food stamp dollars forces stores to compete on price and, unlike healthcare, the prices are transparent. Every paper contains full-page ads in which price plays a dominant role.

This proposal makes certain that the poor have the wherewithal to pay for their healthcare not by forcing them to wait or take poorer quality, but with healthcare dollars. These healthcare dollars are full dollars to providers, insuring that the poor can complete for resources with all other buyers of care.

via Reforming Medicaid with Health Stamps | The Beacon.

Obamacare’s not-so essential benefits

Posted on January 22, 2013 by Brian Schwartz

In the Providence Journal, Sally Pipes of the Pacific Research Institute writes:

Federal officials at the Department of Health and Human Services just finalized rules governing health insurance for individuals and small businesses purchased through Obamacare’s new exchanges. The announcement brings us a step closer to a health-care system wherein spending continues to grow rapidly while basic coverage remains unaffordable.

Just look at what will be considered “Essential Health Benefits” (EHB). Starting in 2014, insurance plans must cover everything from mental-health and drug-abuse treatments to dental and vision for children — regardless of
whether patients want or need them.

Mandating such generous health plans for all will surely drive premiums through the roof. …

In Connecticut, for instance, insurance mandates account for 22 percent of premiums for group coverage and 18 percent for individual plans, according to the University of Connecticut’s Center for Public Health and Health Policy. …

Indeed, patients between ages 18 and 24 can expect their premiums to rise by roughly 45 percent. Those aged 25 to 29 will see a 35 percent jump, according to a study from Oliver Wyman, a consultancy. The same study showed that a three-to-one age band would drive half a million young Americans out of the insurance market.

John Lott: The Facts About Assault Weapons and Crime

Posted on January 21, 2013 by Brian Schwartz

Jon R. Lott, Jr. writes in the Wall Street Journal:

Yet despite being at the center of the gun-control debate for decades, neither President Obama nor Ms. Feinstein (the author of the 1994 legislation) seems to understand the leading research on the effects of the Federal Assault Weapons Ban. In addition, they continue to mislabel the weapons they seek to ban. …

Ms. Feinstein points to two studies by criminology professors Chris Koper and Jeff Roth for the National Institute of Justice to back up her contention that the ban reduced crime. [But these authors concluded just the opposite]. …

The large-capacity ammunition magazines used by some of these killers are also misunderstood. The common perception that so-called “assault weapons” can hold larger magazines than hunting rifles is simply wrong. Any gun that can hold a magazine can hold one of any size. …

Ms. Feinstein’s new proposal also calls for gun registration, and the reasoning is straightforward: If a gun has been left at a crime scene and it was registered to the person who committed the crime, the registry will link the crime gun back to the criminal.

Nice logic, but in reality it hardly ever works that way. Guns are very rarely left behind at a crime scene. When they are, they’re usually stolen or unregistered. …

If we finally want to deal seriously with multiple-victim public shootings, it’s time that we acknowledge a common feature of these attacks: With just a single exception, the attack in Tucson last year, every public shooting in the U.S. in which more than three people have been killed since at least 1950 has occurred in a place where citizens are not allowed to carry their own firearms.

Read the whole article: John Lott: The Facts About Assault Weapons and Crime – WSJ.com.

The Threat Posed by Gun Magazine Limits

Posted on January 17, 2013 by Brian Schwartz

At Reason, Jacob Sullum writes:

[C]hanging magazines takes one to three seconds, which will rarely make a difference in assaults on unarmed people.

Magazine size is more likely to matter for people defending against aggressors, which is why it is dangerously presumptuous for the government to declare that no one needs to fire more than X number of rounds. As self-defense experts such as firearms instructor Massad Ayoob point out, there are various scenarios, including riots, home invasions, and public attacks by multiple aggressors, in which a so-called large-capacity magazine can make a crucial difference, especially when you recognize that people firing weapons under pressure do not always hit their targets and that assailants are not always stopped by a single round. …

If magazines holding more than 10 rounds are not useful for self-defense and defense of others, shouldn’t the same limit be imposed on police officers and bodyguards (including the Secret Service agents who protect the president)? And if the additional rounds do provide more protection against armed assailants, it hardly makes sense to cite the threat of such attacks as a reason to deny law-abiding citizens that extra measure of safety.

Colorado Health Benefit Exchange: bare-bones and expensive plans

Similar Posts:

Arkansas Deal with HHS on Medicaid Expansion a Model for Colorado

Similar Posts:

Twelve Reasons Colorado should say no to Medicaid expansion

Similar Posts:

LA Times: “States worry about rate shock during shift to new health law “

Similar Posts:

Plan for fighting Obamacare: Delay, Repeal, Replace

Similar Posts:

Paul Hsieh, MD: Why Doctors Should Not Ask Their Patients About Guns

Similar Posts:

Reforming Medicaid with “Health Stamps”

Similar Posts:

Obamacare’s not-so essential benefits

Similar Posts:

John Lott: The Facts About Assault Weapons and Crime

Similar Posts:

The Threat Posed by Gun Magazine Limits

Similar Posts:

Categories

health policy sites

health policy primers

HR 3590 "ObamaCare"