Obama Administration Announces Increase In Payments To Medicare Advantage Plans

Presumably in response to Republican scare stories about Medicare cuts to Medicare Advantage plans and insurance company lobbying, CMS has announced an increase in payments of  0.4% in 2015, in place of the expected 1.9% rate cut as of February. This negates a distorted Republican attack that Obama is cutting payments to Medicare.

The proposed cuts were to what is essentially corporate welfare for insurance companies running  Medicare Advantage plans. The plans increased payment compared to what it costs to care for similar patients in the government Medicare plan. Republicans have included the same cuts which were previously proposed by the Obama administration in their proposed budgets despite faux attacks against Democrats for cutting Medicare.

Update: Full Text of Press Release from CMS

CMS Ensures Higher Value and Quality for Medicare Health and Drug Plans

Rate Announcement Details Plan Payments and Other Program Updates for 2015

Today, the Centers for Medicare & Medicaid Services (CMS) issued the 2015 rate announcement and final call letter for Medicare Advantage and prescription drug benefit (Part D) programs. The announcement sets a stable path for Medicare Advantage and implements a number of policies that ensure beneficiaries will continue to have access to a wide array of high quality, high value, and low cost options while making certain that plans are providing value to Medicare and taxpayers.

Since the Affordable Care Act was passed in 2010, Medicare Advantage premiums have fallen by 10 percent and enrollment has increased by 38 percent to an all-time high of more than 15 million beneficiaries. Today, nearly 30 percent of Medicare beneficiaries are enrolled in a Medicare Advantage plan. Furthermore, enrollees are benefiting from greater quality as over half of enrollees are now in plans with 4 or more stars, a significant increase from 37 percent of enrollees in such plans in 2013.

 “The policies announced today will provide improved benefits in Medicare Advantage and the Prescription Drug Plans while keeping costs low for Medicare beneficiaries,” said Jonathan Blum, CMS principal deputy administrator. “We believe that plans will continue their strong participation in the Medicare Advantage program in 2015 and beneficiaries will continue to have access to a wide array of high quality and affordable Medicare health and drug plans.”

After careful consideration of public comments, key changes and updates finalized in the Rate Announcement and final Call Letter include:

Lower Out-of-Pocket Drug Spending: Beneficiaries in the Part D prescription drug coverage gap, or “donut hole,” will benefit from greater savings on prescription drugs. As a result of the Affordable Care Act, in 2015, enrollees who reach the donut hole will receive coverage and discounts of 55 percent on covered brand name drugs and 35 percent on covered generic drugs, an increase from 52.5 percent and 28 percent, respectively, in 2014. The Affordable Care Act’s Coverage Gap Discount Program has provided discounts to more than 7.9 million Medicare beneficiaries, saving $9.9 billion on prescription drugs, or an average of $1,265 per beneficiary.

Greater Protection for Beneficiaries: CMS intends to again use its authority, provided by the health care law, to protect Medicare Advantage enrollees from significant increases in costs or cuts in benefits, and, for the 2015 contract year, finalizing the permissible amount of increase in total beneficiary cost to $32 per member per month (down from $34 per member per month for the 2014 contract year). CMS also continues to require plans to refine their offerings so that beneficiaries can easily identify the differences between their options.

Increased Protections for Beneficiaries Affected by Changes in Medicare Advantage Plan Networks: The final Call Letter strengthens tools used to ensure compliance with established provider access requirements and establishes best practices for Medicare Advantage Organizations to follow when they make significant changes to their provider networks.

Payments to Medicare Advantage Plans:

  • CMS estimates that the overall net change to plan payments between 2014 and 2015 to be +0.4 percent, compared to the estimated overall net change to plan payments of -1.9 percent for the proposals in the Advance Notice   Individual plan payments will vary by plan based on, but not limited to, its location and star rating.
  • Before the Affordable Care Act, Medicare Advantage plans were paid more than 10 percent compared to traditional Medicare, costing the program more than $1,000 per person each year, while quality and health outcomes were similar to those enrolled in traditional Medicare. The changes underway reduce excessive payments to Medicare Advantage plans, while incentivizing quality improvements by basing part of Medicare Advantage payment on plan quality performance.
  • To provide for continued stability in the Medicare Advantage program, CMS will implement a new phase-in schedule for the Part C risk adjustment model introduced in 2014. In addition, to improve payment accuracy, CMS has refined its risk adjustment methodology to account for the impact of the influx of baby boomers. In addition, for 2015, CMS will not finalize the proposal to exclude diagnoses from enrollee risk assessments.

Other policies that are not being finalized as proposed include:

Delayed implementation of new Part D Risk Adjustment Model.

Not implementing some proposed changes to the Star Ratings.

Not implementing the proposal to require additional coverage in the gap for generic and brand drugs in Enhanced Alternative plans.

To view a fact sheet on the 2015 Rate Announcement and final Call Letter, please visit: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-04-07.html

The 2015 Rate Announcement and final Call Letter may be viewed later today through: http://www.cms.hhs.gov/MedicareAdvtgSpecRateStats/ and selecting “Announcements and Documents.”

Update II: The mainstream media is starting to pick up the news. Here are reports from AP and from The Hill.

Cross posted at The Moderate Voice
Please Share

Obama Delivers “The Best Medicine” To Ted Cruz, John Boehner, and Michele Bachmann

CV1_TNY_04_14_14Blitt.indd

Barry Blitt said this about the above cover for The New Yorker: “This whole enterprise was just an elaborate excuse. I enjoyed drawing Ted Cruz, John Boehner, and Michele Bachmann as petulant children—and I especially wanted to draw an open-mouthed Mitch McConnell being spoon-fed his meds.”

Obama is certainly delivering the “medicine” as news comes in showing that enrollment in the Affordable Care Act exceeded projections of seven million, and the number of uninsured is falling to new lows. While good for the United States, this is certainly bitter medicine for Republicans. There is additional bitter medicine for Mitch McConnell as the number signing up in Kentucky exceeded 360,000 with 75 percent previously uninsured.

Cross posted at The Moderate Voice

Please Share

Republicans Had To Hide Support For Fix To Affordable Care Act To Limit Attacks From The Right

The “doc fix”  has become a strange legislative tradition as Congress regularly votes to stop the automatic  cuts in physician payment called for under the flawed Sustainable Growth Rate formula. As I discussed in March, this time there were a couple of new twists which were known, but in addition it turns out that another item hidden in the bill reveals a lot about the Republican Party.

First I’ll recap what we had already known. The “doc fix” proposed to block the cuts which would have taken effect in April was for one year and included multiple other measures, including a delay in implementing change to ICD-10 diagnosis codes until at least October 2015. Physician groups actually opposed this bill because a permanent fix was also under consideration and it was feared that passing yet another temporary fix would lead to abandonment of the permanent fix (which does now appear dead).

The “doc fix” regularly passes with bipartisan support because Congress is not going to risk the backlash which would be created if many Medicare patients could no longer find physicians willing to accept them. This time the House passed the “doc fix” on a voice vote, which allows individual members to avoid being held accountable for the vote.

Over the weekend we learned why House Republicans wanted to pass this on a voice vote. Another item in the bill made some changes in the Affordable Care Act which was desired by small business and which Democrats were willing to make:

At the prodding of business organizations, House Republicans quietly secured a recent change in President Barack Obama’s health law to expand coverage choices, a striking, one-of-a-kind departure from dozens of high-decibel attempts to repeal or dismember it.

Democrats describe the change involving small-business coverage options as a straightforward improvement of the type they are eager to make, and Obama signed it into law. Republicans are loath to agree, given the strong sentiment among the rank and file that the only fix the law deserves is a burial.

“Maybe you say it helps (Obamacare), but it really helps the small businessman,” said Rep. Phil Roe, R-Tenn., one of several physician-lawmakers among Republicans and an advocate of repeal.

No member of the House GOP leadership has publicly hailed the fix, which was tucked, at Republicans’ request, into legislation preventing a cut in payments to doctors who treat Medicare patients.

It is unclear how many members of the House rank and file knew of it because the legislation was passed by a highly unusual voice vote without debate.

This shows how dysfunctional Congress has become. Normally both parties would see it as a victory for the system that they passed a measure to make requested changes in the Affordable Care Act. However, Republicans felt compelled to hide this vote because it contradicts their public policy of only supporting repeal (having voted for repeal over fifty times). Since this became public, the Republicans have faced criticism from the right, probably making it even harder for them to vote on improvements in the Affordable Care Act in the future.

The fix which passed allows small businesses to offer policies with higher deductibles. This allows for lower premiums, and the higher deductibles are often handled separately with Medical Savings Accounts. There are also added protections in new insurance policies under the Affordable Care Act such as annual limits on out of pocket expenses and the elimination of annual and lifetime caps on coverage which help offset the problems created by higher deductibles.

If Republicans should attack the Affordable Care Act based upon including high deductible plans, keep in mind that this is exactly the type of plan which Republicans frequently advocate, and that the Republicans voted to increase the allowable deductible levels in response to requests from small business.  Democrats had no objection to the change as the limit on deductions was originally placed in the bill because it was supported by Republican Senator Olympia Snowe. In response to this addition, Snowe voted for the Affordable Care Act when in the Senate Finance Committee but ultimately voted against the bill on the Senate floor, along with every other Republican Senator.

Cross posted at The Moderate Voice

Please Share

Gallup Finds Number Of Uninsured Continues To Fall

Percent Uninsured

New figures from Gallup show a further decrease in the number saying they are uninsured. The number of uninsured decreased to 15.6 percent in the first quarter of this year, a 1.5 percent decrease from the fourth quarter of 2013. This is the lowest recorded level since late 2008 and suggests that the Affordable Care Act is successful in providing insurance to the previously uninsured. This also shows a further decrease from a similar survey conducted last month.

The uninsured rate has been falling since the fourth quarter of 2013, after hitting an all-time high of 18.0% in the third quarter — a sign that the Affordable Care Act, commonly referred to as “Obamacare,” appears to be accomplishing its goal of increasing the percentage of Americans with health insurance coverage. Even within this year’s first quarter, the uninsured rate fell consistently, from 16.2% in January to 15.6% in February to 15.0% in March. And within March, the rate dropped more than a point, from 15.8% in the first half of the month to 14.7% in the second half — indicating that enrollment through the healthcare exchanges increased as the March 31 deadline approached.

This report is consistent with The Urban Institute’s Health Reform Monitoring Survey (HRMS) which estimated that the number of uninsured adults had fallen by 5. 4 million before the surge in enrollment in March . Another study performed prior to the late March surge in enrollment showed that at least 9.5 million new people received insurance.

Please Share

Paul Ryan Admits Consequences Of Replacing Obamacare With Republican Alternative

Republicans who have been attacking the Affordable Care Act have been unable to provide a specific alternative to replace it with. One problem they face is that, while polls show large numbers of people say they oppose Obamacare, a majority also supports many of the individual components of the law. Paul Ryan admitted what repeal of Obamacare and replacing it with a Republican alternative would mean:

House Budget Committee Chairman Paul Ryan (R-Wis.) says in a new interview that it would be too costly for Republicans to reinstate some of the more popular provisions of Obamacare if and when the law is repealed, but that Republicans should look for alternatives.

The former GOP vice presidential nominee was asked on Bloomberg’s “Political Capital with Al Hunt” about whether Republicans would keep provisions like requiring coverage for pre-existing conditions, keeping kids on their parents’ insurance until they are 26 years old and barring insurance companies from having different rates for those whose jobs include physical labor.

The first two provisions are among the most popular parts of Obamacare, which as a whole is not popular. But Ryan says such provisions would also drive up the cost of insurance too much.

“If you look at these kinds of reforms, where they’ve been tried before — say the state of Kentucky, for example — you basically make it impossible to underwrite insurance,” Ryan said, according to an advance transcript. “You dramatically crank up the cost. And you make it hard for people to get affordable health care.”

Returning to underwriting insurance would mean that insurance companies could once again issue policies based upon who they find the most profitable to cover, denying coverage to those with pre-existing medical conditions and based upon age.

It is less expensive for health insurance companies to sell insurance only to young, healthy people and to revoke coverage when people get sick. However this is not what we need from health insurance, which to be meaningful must be available to everyone and cover people when they become sick. As I’ve pointed out many times in the past, most people going into bankruptcy from medical expenses were insured at the time they first got sick or injured.

Cross posted at The Moderate Voice

Please Share

Study Shows Number of Newly Insured Increased By 5.4 Million As Of Early March

Despite favorable numbers on Obamacare enrollment, many Republicans continue to try to deny the positive results. Two common questions brought up are the number paying their premiums and the number of newly insured. Yesterday I pointed out that those claiming that as many as twenty percent are not receiving coverage due to not paying their premiums are incorrect because often the estimates are made prior to premiums actually being billed or due and as many of the people who drop insurance obtained through the exchanges wind up receiving other coverage. In addition to previous estimates, The Urban Institute’s Health Reform Monitoring Survey (HRMS) estimates that the number of uninsured adults had fallen by 5. 4 million before the surge in enrollment in March . Their survey was concluded on March 6. NBC News reports:

More than 5 million Americans who didn’t have health insurance before have been able to get coverage since September, according to a new report released Thursday.

The report seeks to answer one of the big questions surrounding the government statistics surrounding the law known as Obamacare — how many people have gained health insurance under the new rules? Early statistics had suggested that many of the people who rushed to buy the plans available on the new health insurance exchanges were just swapping out of other coverage.

But the new report suggests the law is having its intended effect of getting people covered who weren’t before.

“This represents a major step forward for 5.4 million previously uninsured people who now have health coverage,” said Dr. Risa Lavizzo-Mourey, president and chief executive officer of the Robert Wood Johnson Foundation, which issued the report along with the Urban Institute.

The report shows that 15.2 percent of Americans were without health insurance as of the first week in March, a drop of 2.7 percentage points since September 2013.

The Obama administration says at least 7.1 million people signed up for private health insurance on the online, health insurance exchanges that opened up in October. Close to three million signed up in March alone, the last month for open enrollment, which is now closed.

Separately, the Obama administration says anyone who started to sign up and wasn’t able to finish by the March 31 deadline has until April 15 to finish.

The exchanges are the centerpiece of the 2010 Affordable Care Act, which seeks in part to get coverage to the 47 million Americans who lacked it as of 2013. The Congressional Budget Office projects that 26 million people will buy health insurance on the exchanges by 2022 and that 12 million people will become newly eligible for Medicaid in the states that choose to expand their offerings by 2022.

So far 26 states, plus the District of Columbia, have decided to offer Medicaid to more people as requested under the law. The report issued Thursday doesn’t include any separate estimates of how many people this might be, and also doesn’t include young adults added because of a provision allowing people to stay on their parents’ health insurance up to age 26.

“The survey does not capture the enrollment surge that occurred at the end of the open enrollment period,” the report adds — that would be the 3 million or more people who signed up in March.

This shows that the number of uninsured has already been falling before the March surge, when Republican critics of the ACA were claiming that most of those signing up for coverage were people who had previously been dropped from their health care plans. The percentage of uninsured will drop further as those enrolling in March and April are included, along with those obtaining expanded Medicaid coverage throughout the year.

Cross posted at The Moderate Voice

Please Share

Many Of Those Not Paying Obamacare Premiums Obtain Alternate Health Care Coverage And Remain Insured

Now that we have data on the number of people who have signed up through the exchanges there remains a question as to how many will actually pay their premiums and obtain coverage. It is not possible to have an exact number on this as coverage for those who signed up in the late April surge doesn’t start until May 1 and the premiums aren’t due until mid April

National Journal repeats estimates which have been floating around that 15 to 20 percent have not paid premiums. Other estimates have placed this at 10 to 15 percent. The report does make a major error in making assumptions about how many are actually covered based upon these numbers: “If the nationwide payment rate, across all carriers, remains at 80 to 85 percent, the 7.1 million sign-ups Obama announced Tuesday would translate into somewhere between 5.7 and 6 million people who are actually covered.”

This conclusion is erroneous as it suggests that those who do not pay their premiums remain uninsured. Kaiser Health News has found that a large number of those not paying their premiums are not paying because of receiving alternate insurance coverage, not because of remaining uninsured:

Why Some Don’t Pay Their Obamacare Premium: It’s Not What You Think

A new analysis finds that many people who signed up for a Covered California health insurance exchange plan are likely to drop the coverage for a good reason: They found insurance elsewhere.

Researchers at the U.C. Berkeley Labor Center released estimates Wednesday showing that about 20 percent of Covered California enrollees are expected to leave the program because they found a job that offers health insurance. Another 20 percent will see their incomes fall and become eligible for Medi-Cal, the state’s insurance program for people who are low income.

In addition to the 40 percent of enrollees who move to Medi-Cal or job-based insurance, between 2 and 8 percent of those who sign up for Covered California are estimated to become uninsured, the analysis noted.

This process — “churn” to those who study health insurance — is well-known in the Medi-Cal and individual insurance market.

According to the report between 53 and 58 percent of Covered California enrollees are expected to stay in a Covered California plan for 12 months. This analysis is consistent with a Kaiser Family Foundation study published earlier this year. It found that of people who enrolled in an individual insurance plan in 2010, years before the health law fully kicked in, only about 48 percent were still in the individual market two years later. (Kaiser Health News is an editorially independent program of the foundation.)

The question of how many people have paid their premium has become a political issue, with questions being raised about the true enrollment in an ACA plan. But Ken Jacobs, chair of the Labor Center and an author of the new study, said that even 15 percent non-payment of premiums “was not a surprising number.”

He said that according to the analysis, in any 3-month period, an estimated 10 percent of enrollees could be expected to leave Covered California, although he says that indeed some may leave the exchange “because the cost was too high.”

On Monday, Peter Lee, executive director of Covered California said 87 percent of enrollees had paid their premium.

Besides disproving the assumption that not paying premiums indicates that people remain uninsured, it is also notable that thirteen percent have not paid their premium, a lower number than reported by National Journal. The number may decrease further as those who enrolled in late April pay their premiums when due.

Update: ACASignups.net notes additional errors in the numbers given in the article from National Journal and estimates that those actually paying their premiums might be as high as 95%. Lower numbers estimated by others are due to numbers from dates before the premiums are actually billed or due.

Cross posted at The Moderate Voice

Please Share
Posted in Health Care. No Comments »

Good News On Obamacare Enrollment Leading To More Favorable Coverage

Democrats have suffered damage from the Affordable Care Act far more from negative press than actual negative results. Of course they make the problem far worse by running away as opposed to standing up for the successes of the Affordable Care Act. Two stories last fall did the most harm–the failed roll out and news of people receiving cancellation letters. The computer problems were IT issues which have nothing to do with the benefits of the Affordable Care Act as policy. Now that we have some data on enrollment, we know that the initial IT problems did not decrease enrollment at all from initial projections. We also now know that most of the people who received cancellation letters received alternate coverage, frequently from the same company, with better coverage at a lower price.

Bad news tends to lead to more bad news but good news often leads to more good news, and hopefully the Democrats will show the ability to capitalize on it. Republicans who made claims of Obamacare leading to fewer people having coverage or failing to meet projections look as foolish as the Republicans who ignored the polls and projected a Romney victory in 2012. Instead of negative stories, we are seeing stories such as this from Politico: Obamacare critics: Homina, homina, homina:

Back in the fall, conservatives seized on the flubbed Obamacare rollout as proof that President Barack Obama’s brand of liberalism doesn’t work.

Now, the law’s opponents aren’t about to say that critique was wrong — but they’ve lost the best evidence they had.

On Tuesday, Obamacare sign-ups passed 7 million, six months after the launch of a federal website that could barely sign up anybody. There are still a lot of questions about how solid that figure is, but the idea that the law could even come close to the original goal after such a disastrous start would have been laughable even a few weeks ago.

It was also a wake-up call for Republicans and conservatives, and even the occasional liberal, who pushed the argument that the failed website challenges the idea at the heart of Obama’s agenda — that government can still solve big social problems.

Of course Fox and other right wing outlets are still running negative headlines, but otherwise success is leading to the rest of the media being more positive. While conservatives spread false stories of Obamacare nightmares, there are more stories on those who benefit under the Affordable Care Act. The New York Times has pointed out that many people have purchased insurance directly from insurance companies in addition to the over seven million purchasing through the exchanges:

Millions of newly insured people are hiding in plain sight.

They are the people who have bought new health insurance since the start of this year but have chosen for one reason or another to bypass the state and federal exchanges that opened last year under the Affordable Care Act. While the exact number is unknown, some health care experts estimate that it may be in the millions.

Politicians and policy makers have focused on the number of people who signed up through the exchanges — at nearly seven million and counting a day after the March 31 deadline — but they have largely overlooked the group that did not use the exchanges, even though it could have a major impact on the program’s financial success in the years ahead…

All individual health insurance plans offered after Jan. 1 must adhere to several new requirements, regardless of whether they are bought through the marketplaces. Insurers must offer more comprehensive coverage and charge healthy and sick people the same rates. And they can no longer turn people away if they have existing medical conditions.

It makes little difference to insurers how the new customers arrive at their door: What matters most is that they get there. Insurers must bring in enough new customers, including a significant number of healthy ones, to offset the higher costs of complying with the law.

Aaron Billger, a spokesman for Highmark, an insurer that offers plans in Delaware, Pennsylvania and West Virginia, said about 30 percent of the approximately 133,000 members that Highmark had enrolled as of mid-March had signed up outside the marketplaces. The large insurer WellPoint, which has said it expects to enroll about one million customers nationwide in new plans, has reported that about 20 percent of its sign-ups have occurred off the exchanges.

Some people are saving money by purchasing insurance from co-ops which are being set up in some states thanks to the Affordable Care Act as an alternative to the large insurance companies. It is too soon to tell whether they will really lower costs, but they do sound like a promising alternative:

The names of the big health insurance companies are familiar – Blue Cross, Aetna, United Healthcare. But what about CoOportunity Health, or Health Republic Insurance of New York?  These are among 23 new health insurance companies that started under the Affordable Care Act.  They’re all nonprofit, member-owned cooperatives, and the aim is to create more competition and drive prices down…

“In some states, co-ops are dominating the marketplace, with 80 percent of the enrollees going to the co-op,” he says.

That’s in Maine. Morrison says most co-ops are very happy with their enrollment numbers. Their rates are often the lowest available through an exchange.

“The co-op states have 8.4 percent lower premiums on average than the non-co-op states, across the marketplace,” says Morrison. “So co-ops are creating that competition. They’re keeping rates down in the states they’re operating in.”

The Los Angeles Times told the story of a cancer patient who benefited from Obamacare:

Robertson wrote a passionate account of his cancer and posted it on the White House website to illustrate how important insurance is even for younger people. Noting that he had paid just 1% of the $900,000 cost for five surgeries, radiation and chemo, he wrote, “Without that, I would have bankrupted my family just to stay alive.”

And without Obamacare’s guarantee that he could buy affordable insurance despite his preexisting medical condition, he wrote, “there’s no telling what life would have been like for us moving forward.”

A major benefit of the Affordable Care Act is to enable people to obtain coverage on the individual market who had difficulty obtaining coverage in the past, when most coverage outside of government programs came from large businesses. There have already been stories on some of the winnersPolitico reported on how Obamacare has helped self-employed artists and actors:

Abromaitis is among the hundreds of thousands of artists, musicians, dancers, actors and filmmakers around the country who especially stand to gain under Obamacare, either through the plans and premium subsidies available on its new insurance exchanges or from the plans employers must start offering.Typically a well-educated but lower-earning demographic — whose members are self-employed more often than not — these Americans have frequently struggled to buy insurance on their own. Some were able to afford union plans, but others paid for costly coverage on the individual market or went without it despite the risk.

A survey last year by The Actors Fund found that 43 percent of individuals working in the visual and performing arts lacked coverage, more than double the national uninsured rate. More than a third of those who had coverage said they got it on the individual market, compared with the 6 percent of Americans generally who turn there for health insurance.

Many are now flocking to Obamacare’s federal- and state-run exchanges, hoping for a way to get covered without breaking the bank. They’re finding both good and bad: more affordable plans but sometimes narrow provider networks and high deductibles.

The narrow provider networks and high deductibles did come as a surprise to some but this has actually been a characteristic of insurance sold through the individual market for a long time. When I purchased new coverage (directly from the insurance company, bypassing healthcare.gov), there was a choice of policies with more restrictive networks with a lower premium, along with choices without restrictive networks but with a higher premium. Most people who wind up in plans with the most restrictive network did so out of a choice to save money. The choices I saw were no different from the choices offered prior to the Affordable Care Act. The difference was that the coverage was far more comprehensive, had new limits on out of pocket expenses, and could never be canceled due to medical problems.

There is far  more good news this week on the Affordable Care Act. Hopefully the Democrats will finally stop being scared of negative and false attacks from Republicans and go on the offensive and develop a new message to take political advantage of the law they passed.

Cross posted at The Moderate Voice

Please Share

Obamacare Enrollment Surpasses Seven Million

The number of people purchasing insurance under the Affordable Care Act has exceeded seven million. This slightly surpasses initial predictions. This also surpasses the reduced prediction of six million made by the Congressional Budget Office as a result of the initial IT problems, (with more expected to sign up in future years) and shows that conservative opponents of Obamacare were wrong in predicting lower numbers.

Millions more purchased health insurance directly from insurance companies. This also does not include the newly insured due to Medicaid expansion or due to students being able to remain on their parents’ policy until age 26. Even when estimates come in including those covered by Medicaid expansion, the number can continue to grow as there is no deadline for signing up for Medicaid. In Michigan the Medicaid program did not even begin taking enrollments until today. There are also some situations in which people can purchase insurance offered through the exchanges after the deadline, such as in case of loss of job or divorce.

There are not yet accurate numbers nationally regarding the number of people signing up who previously had insurance versus those newly insured.

Conservatives are raising questions regarding how many people have not paid premiums and ultimately will not keep this insurance. Estimates on this are premature as coverage for those signing up in late March does not begin until May and premiums will not even be due until mid April.

These numbers are already out of date in light of the surge of people signing up at the last moment, but The Los Angles Times reported on Monday that Obamacare has led to coverage for at least 9.5 million new people:

• At least 6 million people have signed up for health coverage on the new marketplaces, about one-third of whom were previously uninsured.

• A February survey by consulting firm McKinsey & Co. found 27% of new enrollees were previously uninsured, but newer survey data from the nonprofit Rand Corp. and reports from marketplace officials in several states suggest that share increased in March.

• At least 4.5 million previously uninsured adults have signed up for state Medicaid programs, according to Rand’s unpublished survey data, which were shared with The Times. That tracks with estimates from Avalere Health, a consulting firm that is closely following the law’s implementation.

• An additional 3 million young adults have gained coverage in recent years through a provision of the law that enables dependent children to remain on their parents’ health plans until they turn 26, according to national health insurance surveys from the federal Centers for Disease Control and Prevention.

• About 9 million people have bought health plans directly from insurers, instead of using the marketplaces, Rand found. The vast majority of these people were previously insured.

• Fewer than a million people who had health plans in 2013 are now uninsured because their plans were canceled for not meeting new standards set by the law, the Rand survey indicates.

Conservatives have falsely claimed that due to the cancellations of insurance there is a net decrease in the number insured. Most of those who received cancellation notices have received alternative insurance plans, often from the same insurance company. Those who qualify for subsidies are receiving coverage at a lower rate. Everyone who changed from the old plans to new plans on the individual market benefit from changes such as being safe from losing their insurance if they become ill and their insurance company would prefer to stop covering them to save money. The new policies also have annual limits on out of pocket expenses and do not have lifetime caps on coverage as old plans often did.The above data is consistent with Gallup polling showing a decrease in the number of uninsured:

The decrease parallels a similar drop recorded by Gallup, which found in its national polling that the uninsured rate among adults had declined from 18% in the final quarter of last year to 15.9% through the first two months of 2014. Gallup’s overall uninsured rate is lower than Rand’s because it includes seniors on Medicare.

Gallup Editor in Chief Frank Newport said that March polling, which has not been released yet, indicates the uninsured rate has declined further.

“While it is important to be cautious, the logical conclusion is that the law is having an effect,” he said.

Although estimates vary, about 45 million to 48 million people are believed to have been uninsured before the marketplaces opened last year.

The Courier-Journal estimates that about 75 percent of those signing up through the state-run exchange in Kentucky were previously uninsured.

The goal of the ACA was to help cover 48 million Americans, including 640,000 in Kentucky, who lack health insurance.

Although the state set no official first-year goal, its 360,000-plus sign-ups — 75 percent of whom were previously uninsured — represents a sizable chunk.

Although Obama said that the success of enrollments for the Affordable Care Act means “the debate over repealing this law is over,” Republicans are not likely to stop fighting and spreading misinformation. They know that this will help improve Republican turn out this fall. The Koch-financed Americans for Prosperity has put out additional dishonest ads.

Fox, the propaganda organ for the Republican Party, has generally spread their misinformation, including an attempt to distort interpretation of the number of people signing up. Even Fox has not been entirely consistent in backing the Republicans.  On Monday Jenna Lee asked Senator Lindsey Graham why the Republicans have not offered an alternative to the Affordable Care Act despite repeatedly voting to repeal it.

Cross posted at The Moderate Voice

Please Share

Another Study Showing No Medical Benefits From Prayer

Periodically there have been reports in which someone actually bothered to compare medical outcomes with and without prayer. As expected, no benefit was found from situations in which someone was praying for someone else without their knowledge (to remove any psychological benefits). Irregular Times has reported on another study:

Does prayer really work wonders? Not according to epidemiologst Maria Inês da Rosa.

Da Rosa and her research team published results of a double-blind randomized trial in the Brazilian Journal of Science and Public Health last year. Half of the more than five hundred pregnant women in the trial had their health prayed for from a distance by a prayer team. The other half received no such prayers. When Da Rosa’s team measured the apgar scores, type of delivery and birth weight of the two groups, there was no difference in pregnancy outcomes.

A few years ago, intercessory prayer researchers were promising a golden age in which they would supposedly prove the effectiveness of their religion. That’s not happening. Careful science is establishing the opposite.

Please Share