Obamacare exploding? Maybe just a slow burn

[rooster59]

Obamacare exploding? Maybe just a slow burn

By Caroline Humer and Yasmeen Abutaleb

 

Activists protest against the Republican plan to repeal Obamacare during a rally in Freedom Plaza in Washington March 23, 2017. REUTERS/Kevin Lamarque

 

NEW YORK/WASHINGTON (Reuters) - U.S. President Donald Trump said on Friday that Obamacare was "exploding" after Republican lawmakers shelved legislation that would have dismantled the healthcare law.

 

That's not going to happen this month. Probably not even this year.

 

The more than 12 million people who bought 2017 health insurance plans on HealthCare.gov and other websites the law created are not in danger of losing their healthcare or having their premiums go up right now, experts say.

 

But 2018 is another story.

 

Republicans could choose to pass a budget that defunds Obamacare's cost-sharing subsidies, which help low-income people cover out-of-pocket and other medical costs. But that would be highly unpopular among consumers who would likely blame the president and Congress for skyrocketing healthcare costs, experts said.

 

"That is one of the ways that is available to monkey wrench the Affordable Care Act," said Morgan Tilleman, an associate with the law firm Foley & Lardner, who represents insurers.

 

Obamacare, former Democratic President Barack Obama’s signature legislation created by the Affordable Care Act of 2010, has had a tough beginning. The mix of sick and healthy customers has been worse than expected, and premium rates on the individual insurance market went up 25 percent this year.

 

Other parts of the law, like the expansion of Medicaid to enhance coverage for the poor, and changes to allow young people to stay on their parents' health plans, have been popular. And the defeat of the bill is a win for the hospitals that have benefited from those increased Medicaid dollars.

 

But many counties across the country have only one insurer, after Humana Inc, Aetna Inc and UnitedHealth Group Inc pulled out after reporting hundreds of millions of dollars of losses.

 

The insurers who are left, Anthem Inc and other BlueCross BlueShield insurers across the country, as well as smaller players like Centene Corp and Molina Healthcare Inc need to decide in the next few months where to sell insurance and how much to charge.

 

And that is where the market's slow burn takes off, with insurers leaving and premiums rising.

 

Jeff Jonas, a portfolio manager at Gabelli Funds who focuses on health care, said that for for consumers, 2018 looks uncertain, with a "death spiral" of decreasing competition and increasing premium rates ramping up.

 

LOOKING TO 2018

 

After the failed Republican effort to push through the bill, insurers are looking at changes to help 2018, America's Health Insurance Plans spokeswoman Kristine Grow said.

 

That includes the market's cost-sharing subsidies as well as other government payments for sicker-than-usual customers and finalizing a rule the Trump administration proposed that addresses issues insurers say drives up costs.

 

The Trump administration could do some of that itself if it wants to, such as using its regulatory authority to adjust the formula for how it compensates insurers for the sickest people, Elizabeth Carpenter at healthcare consultancy and research firm Avalere Health said.

 

But it is unknown if the administration will try to work within the law's existing framework or take actions to undermine it and blame the Democrats for its failure.

 

"If they fail to act and they don't act in an appropriate way, that will further destabilize the marketplace," Dr. Mario Molina, CEO of Molina Healthcare, said. Molina's enrollment ballooned to 1 million exchange enrollees this year and the company is weighing if it will submit plans for next year.

 

The administration could also decide to not enforce the individual mandate, which requires that everyone purchase health insurance or pay a fine. It already took steps to erode that provision last month, when it backed off implementing tougher oversight that was due to go into effect for 2016 taxes.

 

Experts said the individual mandate still cost less than purchasing insurance, but as it increases each year more young and healthy people would have incentive to join the healthcare market, helping to offset the cost of sicker patients.

 

The nonpartisan Congressional Budget Office estimated that 14 million more people would be uninsured under the Republican bill next year, with most of the increase coming from the repeal of the penalty associated with the individual mandate.

 

It's unclear what the Republicans will do. Trump said this bill had been shelved but that Republicans would end up with a "great" healthcare bill in the future, but for now that they are moving onto tax reform.

 

Until they do that, they will have to work within the 2010 Affordable Care Act. It can also undercut the healthcare law through regulatory authority at the Department of Health and Human Services.

 

 

-- © Copyright Reuters 2017-03-25

 

[Trouble]

The whole health care situation is a mess and both parties are responsible.  The ACA was an time bomb to begin with.  It tried to encompass too much for too many all at once. It has not been what was promised because from the get go those in the know knew the program could not work and planned on fixes later.  Not well thought out and not read by most of those that voted for it.  Obama's repeated claims were all just lies to sell the program.  Of the 24 million people who have now acquired the health care, half are getting subsidies or are on medicaid, all funded by the taxpayer. Those that foot the bill in higher premiums haven't kept their doctors and have less choices. Basically the act created another entitlement program.

 

The Democrats won't even admit there is a problem, won't enter into talks with the Republicans to work out a solution. They are so hell bent on preserving Obama's legacy program they can't think straight. The Republicans are so hell bent on repealing they won't enter into talks with the Democrats to see how something can be salvaged out of the ACA.  Like spoiled children.

 

Trump is right about one thing and that's the fact that things will get a lot worse before it gets better.  As the article mentioned, those health insurance companies have lost hundreds of millions and they won't continue to stay in the program.  It will go bust on it's own or rely on sucking up more taxpayer money every year. The problem is that instead of starting out with some kind of basic catastrophic care coverage and seeing how it worked and then building on that, they put everything in but the kitchen sink which is entirely unaffordable under that structure they created.  It was all great theory but not practical in reality.

[dunroaming]

The truth is that Trump the great negotiator couldn't negotiate himself out of a paper bag.  He has once again shown that all he has is a bully boy approach and that ain't going to work. 

[DogNo1]

Unaffordable to whom?  The American health care system should be nationalized, cost controls initiated and financing accomplished through a single payer system.  So long as competition is expected to bring costs down, the system will fail.  People should pay for national health care in proportion to their income. Other countries have the correct and humane policies: sufficient taxation to ensure that all of their citizens are well taken care of.  In America, medical and dental care costs are ridiculous with epi-pens at $800 and cheaply-produced essential medicines at astronomical prices.  We need another Theodore Roosevelt now to cut the power of the rich and restore balance to the American economy.

[sirineou]

8 minutes ago, DogNo1 said:

Unaffordable to whom?  The American health care system should be nationalized, cost controls initiated and financing accomplished through a single payer system.  So long as competition is expected to bring costs down, the system will fail.  People should pay for national health care in proportion to their income. Other countries have the correct and humane policies: sufficient taxation to ensure that all of their citizens are well taken care of.  In America, medical and dental care costs are ridiculous with epi-pens at $800 and cheaply-produced essential medicines at astronomical prices.  We need another Theodore Roosevelt now to cut the power of the rich and restore balance to the American economy.

I could not agree more  ^^^^

A single payer system is the only viable option everything else is simply grasping at straws. eventual we will get to that , but until then people will suffer and die.

In the mean time ACA is a federal program, and as such needs to be maintained by the federal government who;s president is Trump. Trump has a vested interest that it fails ,he has said so himself, how well do you think he and his administration will maintain the program, and how active do you think he will be in preventing it;s failure ?

[kowpot]

Those of you living overseas don't have to contribute to the ACA. But, you are quick to criticize those that are left to pay the bill for those that get it for practically free.

I too don't contribute. It is not because I live overseas, it is because I fall under another healthcare program.  But, I have family that is middle class and they are suffering trying to pay for healthcare under the ACA. Even if they get a policy with low premiums, they would have to pay thousands in co-pays. To the point that they just can't use their health insurance policy.

Not that long ago they had policies that were fair, that they could afford. Also, had decent deductibles that they could also afford.  But, that was taken away from them under threat of penalties. 

 Now they are the one's that basically have no healthcare. The records the government are showing you state these people have healthcare, but in truth they don't because they cannot afford to use it.

I feel lucky and blessed that I don't have to depend on the ACA.

[Langsuan Man]

19 hours ago, rooster59 said:

Obamacare exploding? Maybe just a slow burn

Well the burn is going to go a lot quicker with the Republicans controlling the purse strings

 

It was recently revealed that one of the reasons that sign ups are slowing down was because the White House has ended all advertising to encourage people to sign up

 

Quote

Trump White House abruptly halts Obamacare ads

 

The Trump administration has pulled the plug on all Obamacare outreach and advertising in the crucial final days of the 2017 enrollment season, according to sources at Health and Human Services and on Capitol Hill.

source: http://www.politico.com/story/2017/01/trump-white-house-obamacare-ads-234245

[DogNo1]

Ah, yes!  When people can choose whether to sign up, it's a cinch that the young and healthy will usually choose to be uninsured.  Someone has mentioned that some people pay the bill for some people who get health care for free.  That is the way that national health care works.  People who are wealthy pay more and the poor pay less.  People who are young and healthy pay their premiums while they may not need much medical care but when they get older and need treatment and medicine,  their care will be paid for by the younger and healthier people that they once were.  This is the way that it works for countries which have accepted universal health care and a single-payer system.  Not co-incidentally, these countries practice cost containment.  If you examine the statistics, you will find any number of countries that provide good care for a much lower percentage of their GDP.    That will not work in a country such as the USA where the sky is the limit on the price of pharmaceuticals and medical procedures.

A company has just come out with an injection that will drive cholesterol levels unbelievably low for the cost of about $14,000 per year.  Unfortunately, it only improves cardio-vascular outcomes by 15% over those who take regular cholesterol medication by mouth and one favorable outcome is not needing angioplasty and the installation of stents.  To my mind, having read the study, the benefit of the injection is only very optomistically 15%.   (I can point you to the article in the NYTwhere you can look at the figures of study.) The drug company is trying to market this injection while research shows that over 50% of Americans do not have adequate dental care.  Where do you think that the dollars should be put?