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Affordable Care Act (ACA) - Obamacare

What the GOP Talks About When It Talks About Obamacare Now - The Wire

During a live debate with Senate Majority Leader Harry Reid on Friday, Nevada's Republican Sen. Dean Heller was asked which part of Obamacare he would repeal now that the law has enrolled 8 million people. "No one talks about tort reform," he said on News 3's What's Your Point? There's a reason for that. A pet health care reform idea among the GOP is changes to medical malpractice lawsuits — the only problem is tort reform doesn't do anything to lower health care spending. But it shows that as the law continues to do better, Republicans have to reshape their talking points beyond ending it. Here's how the GOP is talking about Obamacare (and the movement to repeal and replace it) now. Notice how they've moved from broadly talking about ending it to smaller complaints about how well it's working:

The House GOP's Obamacare Replacement Package Stumbles in Florida and on Capitol Hill - The Wire
 
Sommers BD. Insurance Cancellations In Context: Stability Of Coverage In The Nongroup Market Prior To Health Reform. Health Affairs. Insurance Cancellations In Context: Stability Of Coverage In The Nongroup Market Prior To Health Reform

Recent cancellations of nongroup health insurance plans generated much policy debate and raised concerns that the Affordable Care Act (ACA) may increase the number of uninsured Americans in the short term.

This article provides evidence on the stability of nongroup coverage using US census data for the period 2008–11, before ACA provisions took effect.

The principal findings are threefold.
• First, this market was characterized by high turnover: Only 42 percent of people with nongroup coverage at the outset of the study period retained that coverage after twelve months.
• Second, 80 percent of people experiencing coverage changes acquired other insurance within a year, most commonly from an employer.
• Third, turnover varied across groups, with stable coverage more common for whites and self-employed people than for other groups.

Turnover was particularly high among adults ages 19–35, with only 21 percent of young adults retaining continuous nongroup coverage for two years.

Given estimates from 2012 that 10.8 million people were covered in this market, these results suggest that 6.2 million people leave nongroup coverage annually.

This suggests that the nongroup market was characterized by frequent disruptions in coverage before the ACA and that the effects of the recent cancellations are not necessarily out of the norm.

These results can serve as a useful pre-ACA baseline with which to evaluate the law’s long-term impact on the stability of nongroup coverage.
 
Opting Out Of Medicaid Expansion: The Health And Financial Impacts
Opting Out Of Medicaid Expansion: The Health And Financial Impacts – Health Affairs Blog

Predicted national-level consequences of states opting out of Medicaid expansion are displayed in Exhibit 2. We estimate the number of deaths attributable to the lack of Medicaid expansion in opt-out states at between 7,115 and 17,104. Medicaid expansion in opt-out states would have resulted in 712,037 fewer persons screening positive for depression and 240,700 fewer individuals suffering catastrophic medical expenditures. Medicaid expansion in these states would have resulted in 422,553 more diabetics receiving medication for their illness, 195,492 more mammograms among women age 50-64 years and 443,677 more pap smears among women age 21-64. Expansion would have resulted in an additional 658,888 women in need of mammograms gaining insurance, as well as 3.1 million women who should receive regular pap smears.
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Ill like to add how many people who have selected they're insurance provider plans via the health market are limited where they can receive practice......... I am witnessing this first hand by the way.
 
How Many People in Each State Are Missing Out on Medicaid Coverage?
In these 24 states, more than 4.8 million people are in health care limbo.

All states' health care plans are not created equal.

Under the Affordable Care Act, states could qualify for expanded Medicaid funds from the federal government as of Jan. 1, 2014. The ACA provides that if a state opts to expand its Medicaid program, the federal government will cover all of the state's costs to cover newly eligible people for the first three years, and at least 90 percent of the costs after that. But in conservative states where opposition to the ACA is running high, many state governments have refused to accept the expansion funds, arguing that Medicaid is a fiscally untenable system.

According to estimates from the Kaiser Family Foundation, that means more than 4.8 million Americans who could have their health insurance covered by the government may instead have to find their own coverage.

The so-called expansion means that each state would be able to increase the number of its residents that qualify for Medicaid coverage. It does so by setting the income eligibility level for Medicaid at 138 percent of the federal poverty line—or approximately $27,000 for a family of three. It would also expand coverage for non-elderly adults who don't have children.
 
Aiming Higher: Results from a Scorecard on State Health System Performance, 2014
http://www.commonwealthfund.org/Publications/Fund-Reports/2014/Apr/2014-State-Scorecard.aspx

The Commonwealth Fund’s Scorecard on State Health System Performance, 2014, assesses states on 42 indicators of health care access, quality, costs, and outcomes over the 2007–2012 period, which includes the Great Recession and precedes the major coverage expansions of the Affordable Care Act. Changes in health system performance were mixed overall, with states making progress on some indicators while losing ground on others. In a few areas that were the focus of national and state attention—childhood immunizations, hospital readmissions, safe prescribing, and cancer deaths—there were widespread gains. But more often than not, states exhibited little or no improvement. Access to care deteriorated for adults, while costs increased. Persistent disparities in performance across and within states and evidence of poor care coordination highlight the importance of insurance expansions, health care delivery reforms, and payment changes in promoting a more equitable, high-quality health system.
 
Insurers Say Most Obamacare Customers Paid First Premiums
Insurers Say Most Obamacare Customers Paid First Premiums - Bloomberg

Three large health insurers including WellPoint Inc. (WLP) and Aetna Inc. (AET) say that a high percentage of their new Obamacare customers are paying their first premiums, undermining a Republican criticism of enrollment in the program.

As many as 90 percent of WellPoint customers have paid their first premium by its due date, according to testimony the company prepared for a congressional hearing today. For Aetna, the payment is in the “low to mid-80 percent range,” the company said in its own testimony. Health Care Service Corp., which operates Blue Cross Blue Shield plans in five states including Texas, said that number is at least 83 percent.
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Death on the Installment Plan
Now we know: Rejecting the Medicaid expansion could kill nearly 6,000 people each year.
http://www.politico.com/magazine/story/2014/05/the-deadliest-republican-policy-yet-106453.html

The uninsured in America are mainly non-elderly adults. Deaths are really rare in this population, on the order of 0.4 percent per year. according to an Urban Institute study. Real-world randomized clinical trials—even those with thousands of patients—are just too small and too brief to reliably determine how much we might reduce mortality by extending coverage to the uninsured.

On Monday, though, a beautiful study was published in Annals of Internal Medicine that provides some of the best data we have connecting health coverage to saved lives.

Here’s their bottom-line result: Insurance coverage reduced mortality rates by about 30 percent. For every 830 people newly insured, Massachusetts prevented one death per year.
 
Sommers BD, Long SK, Baicker K. Changes in Mortality After Massachusetts Health Care Reform: A Quasi-experimental Study. Annals of Internal Medicine 2014;160(9):585-93. Annals of Internal Medicine | Changes in Mortality After Massachusetts Health Care Reform: A Quasi-experimental StudyChanges in Mortality After Massachusetts Health Care Reform

Background: The Massachusetts 2006 health care reform has been called a model for the Affordable Care Act. The law attained near-universal insurance coverage and increased access to care. Its effect on population health is less clear.

Objective: To determine whether the Massachusetts reform was associated with changes in all-cause mortality and mortality from causes amenable to health care.

Design: Comparison of mortality rates before and after reform in Massachusetts versus a control group with similar demographics and economic conditions.

Setting: Changes in mortality rates for adults in Massachusetts counties from 2001 to 2005 (prereform) and 2007 to 2010 (postreform) were compared with changes in a propensity score–defined control group of counties in other states.

Participants: Adults aged 20 to 64 years in Massachusetts and control group counties.

Measurements: Annual county-level all-cause mortality in age-, sex-, and race-specific cells (n = 146 825) from the Centers for Disease Control and Prevention's Compressed Mortality File. Secondary outcomes were deaths from causes amenable to health care, insurance coverage, access to care, and self-reported health.

Results: Reform in Massachusetts was associated with a significant decrease in all-cause mortality compared with the control group (?2.9%; P = 0.003, or an absolute decrease of 8.2 deaths per 100 000 adults). Deaths from causes amenable to health care also significantly decreased (?4.5%; P < 0.001). Changes were larger in counties with lower household incomes and higher prereform uninsured rates. Secondary analyses showed significant gains in coverage, access to care, and self-reported health. The number needed to treat was approximately 830 adults gaining health insurance to prevent 1 death per year.

Limitations: Nonrandomized design subject to unmeasured confounders. Massachusetts results may not generalize to other states.

Conclusion: Health reform in Massachusetts was associated with significant reductions in all-cause mortality and deaths from causes amenable to health care.
 
Another Opponent of Obamacare Starts to Soften
http://www.nytimes.com/2014/05/17/u...xpand-health-care-coverage.html?smid=fb-share

Another die-hard opponent of the Affordable Care Act may be finding a way to expand Medicaid. Few have stood as firm against Obamacare as Gov. Mike Pence of Indiana, but on Thursday he announced a new proposal that would accept federal funds for increased coverage of low-income state residents — though by giving them access to private insurance plans rather than standard Medicaid.
Click to expand...
 
It’s getting hard to ignore insurance numbers
http://theincidentaleconomist.com/wordpress/its-getting-hard-to-ignore-insurance-numbers/

Five percent of Americans report being newly insured in 2014. More than half of that group, or 2.8% of the total U.S. population, say they got their new insurance through the health exchanges that were open through mid-April. http://www.gallup.com/poll/171863/exchanges-close-americans-newly-insured.aspx

This means that more than 15 million Americans are newly insured this year. Almost 9 million of them received private insurance through the exchanges.
 
Now, where are the statistics of those who previously HAD insurance but were priced out of the market. Let's say by a not-so-hypothetical increase from $480/mo to $954/mo. Pretty close to double. I'm kind of disheartened to see Meso become a division of Media Matters. Endless quotes from the liberal media.
 
very happy I happen to work for a company that (for now) still has a decent benefits package. I know a two friends of mine who are self employed who really got the worst of it- their premiums doubled and tripled respectively for slightly less coverage (higher copays). But i just saw a commercial on TV tonight telling people that don't have insurnace should call and "get their Obamacare money because it's free". Guess thats right after you call and get your free cell phone if you are on public assistance too. Makes you really wonder where this country is headed
 
Obamacare is crap and will only make insurance go up. I believe we need a new health care system completely, like how Europe does it and every other industrialized nation.

However that won't happen too much money to bleed from US people for that and this is a business at the end of the day. Obamacare makes it seem like it's making a good system when in fact it's making a worst system that can bleed people even more.
 
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