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The Big Fix

- September 22, 2015

After Being A Champion Of A Law That Has Fueled Problems With Costs And Choice In Health Care, Can We Trust Clinton To Fix Them?

CLINTON'S NEW HEALTH CARE PROPOSALS WILL FIX THE PROBLEMS THAT SHE HELPED TO CREATE IN OBAMACARE

Today, Clinton Will Be Previewing How She Wants To Fix The Mess She Helped To Create: ObamaCare! "Hillary Clinton previewed her fixes to the Affordable Care Act on Monday, telling an audience in Louisiana that while the law it working, there is still more than needs to be done to improve it. Attaching herself to one of President Barack Obama's signature legislative achievements, Clinton used an organizing event in Baton Rouge -- her first in the state as a candidate -- to slam Republican attempts to repeal the law. … Clinton plans to use the coming week -- and a series of events in Little Rock, Arkansas, and Des Moines, Iowa -- to outline what she feels is working in ObamaCare, and more notably, what isn't." (Dan Merica, "Hillary Clinton On Repealing ObamaCare: 'Not On My Watch,'" CNN, 9/21/15)

Clinton Pledged To "Build" On ObamaCare, Citing The Problems Of Rising Costs And Skyrocketing Out Of Pocket Costs. "On Monday, Clinton said she would 'build on the progress' made by ObamaCare, singling out bringing down health care costs, easing burdens on small businesses and increasing choice. Clinton highlighted 'skyrocketing out of pocket health care costs and particularly run away prescription drug prices.'" (Dan Merica, "Hillary Clinton On Repealing ObamaCare: 'Not On My Watch,'" CNN, 9/21/15)

  • Clinton's Policy Proposals "Have Leaned Heavily" On Obama's Accomplishments And Ideas. "Thus far, the former secretary of state's policy proposals have leaned heavily on the Obama administration's accomplishments and on ideas the president has not been able to push through Congress." (Jennifer Epstein, "Hillary Clinton Touts Obama Administration's Support As Joe Biden Mulls Options," Bloomberg , 8/26/15)

AMERICANS ALREADY KNOW WHAT CLINTON'S IDEAS ON HEALTH CARE ARE, PAYING MORE FOR LESS UNDER OBAMACARE

Next Year, Health Care Consumers Will Face Double-Digit Premium Increases

Insurance Regulators Across The County Are Approving Hefty Health Premium Rate Increases Under ObamaCare. "Several regulators around the country agree with her, and have approved all or most of the big premium increases sought by the largest health plans in their states for the new sign-up season that begins Nov. 1." (Louise Radnofsky and Stephanie Armour, "Insurers Win Big Health-Rate Increases," The Wall Street Journal, 8/27/15)

Tennessee's Insurance Commissioner Approved A 36.3 Percent Health Premium Rate Increase For The Largest Health Plan In The State. "That commissioner, Julie Mix McPeak, answered on Friday by greenlighting the full 36.3% increase sought by the biggest health plan in the state, BlueCross BlueShield of Tennessee. She said the insurer demonstrated the hefty increase for 2016 was needed to cover higher-than-expected claims from sick people who signed up for individual policies in the first two years of the Affordable Care Act." (Louise Radnofsky and Stephanie Armour, "Insurers Win Big Health-Rate Increases," The Wall Street Journal, 8/27/15)

Kentucky's Insurance Commissioner Approved A 25.1 Percent Increase For The Largest Insurer In The State. "Kentucky Insurance Commissioner Sharon Clark approved the 25.1% increase requested by the Kentucky Health Cooperative, the largest insurer on the state's insurance exchange. Kentucky has taken a more supportive stance toward the health law, including operating its own insurance exchange rather than using the federal government's Health care.gov." (Louise Radnofsky and Stephanie Armour, "Insurers Win Big Health-Rate Increases," The Wall Street Journal, 8/27/15)

Oregon's Insurance Commissioner Approved A 25.6 Percent Increase For The Biggest Health Plan Sold On The State's ObamaCare Exchange. "Oregon's Laura Cali allowed an average 25.6% increase for Moda Health Plan Inc., the biggest plan on that state's exchange." (Louise Radnofsky and Stephanie Armour, "Insurers Win Big Health-Rate Increases," The Wall Street Journal, 8/27/15)

"In Ohio, Lt. Gov. Mary Taylor Approved A 14.5% Increase From Medical Mutual." (Louise Radnofsky and Stephanie Armour, "Insurers Win Big Health-Rate Increases," The Wall Street Journal, 8/27/15)

"In Michigan, BlueCross BlueShield Won Approval For The Average 11.4 Percent Increase …" "In Michigan, BlueCross BlueShield won approval for the average 11.4% increase from insurance director Patrick McPharlin." (Louise Radnofsky and Stephanie Armour, "Insurers Win Big Health-Rate Increases," The Wall Street Journal, 8/27/15)

Idaho's Insurance Commissioner Approved A 23 Percent Increase Calling The Double-Digit Request, "Not Unreasonable." "In Idaho, insurance director Dean Cameron said that an average 23% increase by Blue Cross of Idaho Health Service Inc., was disappointing but 'not unreasonable' and that he didn't have the power to stop it." (Louise Radnofsky and Stephanie Armour, "Insurers Win Big Health-Rate Increases," The Wall Street Journal, 8/27/15)

Health Care Consumers Are Paying Significantly More In Higher Deductibles And Out-Of-Pocket Costs Under ObamaCare

Under ObamaCare, Deductibles Have Increased By Nearly 50 Percent. "Deductibles rose nearly 50% from 2009 to 2014. Patients also pay 'co-insurance,' a portion of covered costs beyond that." (Laura Ungar and Jayne O'Donnell, "Health Care Costs Are A Medical Mystery," USA Today, 9/21/15)

Health Care Consumers Are Picking Up A "Much Bigger Chunk" Of Their Health Tab Through Deductibles And Out-Of-Pocket Costs. "These days, however, patients are being asked to pick up a much bigger chunk of the tab. That happens first through deductibles, which are what you pay before insurance chips in. Out-of-pocket maximums include deductibles as well as co-pays and co-insurance, but not premiums or cost-sharing when you get care out of network. Maximums for private plans are often lower than $6,600 - sometimes by a lot - they just can't be higher." (Jayne O'Donnell and Laura Ungar, "Maxed Out By Out-Of-Pocket Costs," USA Today, 8/4/15)

  • Patients' Share Of Costs Grew 9.5 Percent For Repeat Health Consumers And 7.9 Percent For New Consumers. "Still, patients are responsible for an increasing portion of their health care costs, mostly due to higher deductibles - and also the fact that more health care services are now subject to ​ deductibles, according to a recent RWJF report that Hempstead co-wrote. From 2013 through 2014, patients' share of their costs grew 9.5% for established patients and 7.9% for new patients." (Jayne O'Donnell and Laura Ungar, "Maxed Out By Out-Of-Pocket Costs," USA Today, 8/4/15)

High-Deductible Plans Are Now A "Mainstay" Of ObamaCare. "And now, they're also the mainstay of the new health insurance exchanges created by Obama's law." (Ricardo Alonso-Zaldivar and Jennifer Agiesta, "Poll: Many Insured Struggle With Medical Bills," The Associated Press , 10/13/14)

  • Deductibles Of "$2,000 And Even Higher Are Common" After ObamaCare. "One government definition sets the threshold for a high-deductible plan at $1,300 for individual coverage, but in practice annual deductibles of $2,000 and even much higher are common." (Ricardo Alonso-Zaldivar and Jennifer Agiesta, "Poll: Many Insured Struggle With Medical Bills," The Associated Press , 10/13/14)

ObamaCare Created "Complex New Health Insurance Products Featuring Legions Of Out-Of Pocket Coinsurance Fees, High Deductibles And Narrow Provider Networks." "The Affordable Care Act has ushered in an era of complex new health insurance products featuring legions of out-of-pocket coinsurance fees, high deductibles and narrow provider networks." (Elisabeth Rosenthal, "Insured, But Not Covered," The New York Times, 2/7/15)

Under ObamaCare, Narrower Provider Networks Are Forcing Health Consumers To Struggle With Accessing Care

ObamaCare Consumers Had Access To "One Third Fewer Doctors And Hospitals On Average, Than People With Traditional Employer-Provided Coverage." "Consumers who bought insurance on the health exchanges last year had access to one-third fewer doctors and hospitals, on average, than people with traditional employer-provided coverage, according to an analysis released Wednesday. The study by consulting firm Avalere Health provides a statistical basis for anecdotal reports from consumers and others about the more limited doctor and hospital choices in plans offered on marketplaces created by the Affordable Care Act." (Lena H. Sun, "ACA Plans Have Fewer Providers," The Washington Post, 7/16/15)

According To Avalere's Analysis, ObamaCare Networks Have "42 Percent Fewer Cancer And Cardiac Specialists; 32 Percent Fewer Mental Health And Primary-Care Doctors, And 24 Percent Fewer Hospitals" Than Traditional Employer Plans. "Compared with traditional employer coverage, exchange plans had networks with 42 percent fewer cancer and cardiac specialists; 32 percent fewer mental health and primary-care doctors, and 24 percent fewer hospitals, the Avalere analysis found." (Lena H. Sun, "ACA Plans Have Fewer Providers," The Washington Post, 7/16/15)

"State And Federal Regulators Have Been Grappling With How To Respond To Consumer Complaints About Skinnier Networks And Inaccurate Information In Provider Directories." (Chad Terhune, "75% Of ObamaCare Plans In California Use Narrow Networks, Study Says," Los Angeles Times, 8/25/15)

  • A Recent Study By Penn University Researchers Found That 41 Percent Of ObamaCare Plans Feature Narrower Physician Networks. "A new study finds that 75% of California's ObamaCare health plans have narrow physician networks -- more limited choices than all but three other states. The latest report examines health plans sold to consumers last year under the Affordable Care Act and shows wide variation in the prevalence of narrow networks across the country. Only Georgia, Florida and Oklahoma had a higher percentage of small provider networks than California did in the insurance company directories analyzed by University of Pennsylvania researchers. Nationwide, 41% of networks were labeled narrow, meaning they included 25% or less of the physicians in a rating area." (Chad Terhune, "75% Of ObamaCare Plans In California Use Narrow Networks, Study Says," Los Angeles Times, 8/25/15)

Americans In Rural Areas Are Unable To Visit Their Local Hospital As ObamaCare's Cuts Have Rapidly Accelerated Closures

ObamaCare Was Promised To Improve Access To Care But Is "Accelerating The Demise" Of Rural Hospitals That Often Care For The Indigent. "The Affordable Care Act was designed to improve access to health care for all Americans and will give them another chance at getting health insurance during open enrollment starting this Saturday. But critics say the ACA is also accelerating the demise of rural outposts that cater to many of society's most vulnerable." (Jayne O'Donnell and Laura Ungar, "Rural Hospitals In Critical Condition," USA Today, 11/12/14)

  • ObamaCare's Cuts In Reimbursements, Medicare And Payments To Hospitals The Care For The Uninsured Are Contributing To The Decline Of Rural Hospitals. "Experts and practitioners cite declining federal reimbursements for hospitals under the Affordable Care Act as the principal reasons for the recent closures. Besides cutting back on Medicare, the law reduced payments to hospitals for the uninsured, a decision based on the assumption that states would expand their Medicaid programs." (Guy Gugliotta, Rural Hospitals, Beset By Financial Problems, Struggle To Survive," The Washington Post , 3/15/15)

Since Around Obama Signed ObamaCare Into Law, Rural Hospital Closures Have Accelerated "From 3 In 2010" To Double Digit Closures In 2013 And 2014. "Since the beginning of 2010, 43 rural hospitals - with a total of more than 1,500 beds - have closed, according to data from the North Carolina Rural Health Research Program. The pace of closures has quickened: from 3 in 2010 to 13 in 2013, and 12 already this year." (Jayne O'Donnell and Laura Ungar, "Rural Hospitals In Critical Condition," USA Today, 11/12/14)

OBAMACARE FAILED TO BEND THE COST CURVE WHILE CONTINUING TO BE A DRAIN ON THE ECONOMY

ObamaCare Is Responsible For The Acceleration In Health Care Spending

ObamaCare Will Contribute To Rapid Increases In Health Care Spending, Which Will Rise "Roughly 6 Percent A Year" By 2019, "Compared To An Average Annual Rise Of 4 Percent From 2008 Through 2013." "A combination of expanded insurance coverage under President Barack Obama's law, an aging population, and rising demand, will be squeezing society's ability to pay. By 2019, midway through the next president's term, health care spending will be increasing at roughly 6 percent a year, compared to an average annual rise of 4 percent from 2008 through 2013." (Ricardo Alonson-Zaldivar, "Health Care Spending To Accelerate, U.S. Report Says," The Associated Press, 7/28/15)

  • "The Nation's Respite From Accelerating Health Care Costs Appears To Be Over. " (Ricardo Alonson-Zaldivar, "Health Care Spending To Accelerate, U.S. Report Says," The Associated Press, 7/28/15)

Health Care Spending "Will Outpace The Nation's Overall Economic Growth Over The Next Decade." "Spending on health care will outpace the nation's overall economic growth over the next decade, the government forecast on Tuesday, underscoring a coming challenge for the next president, not to mention taxpayers, businesses and individual Americans." (Ricardo Alonson-Zaldivar, "Health Care Spending To Accelerate, U.S. Report Says," The Associated Press, 7/28/15)

  • Medicaid Spending Will Nearly Double From 2013 To 2014 Due To ObamaCare's Medicaid Expansion. "Spending on Medicaid, the federal-state health insurance program for low-income people, also has jumped. The 2013 increase was 6.1 percent. But the program is projected to have grown by 12 percent in 2014, again boosted by coverage expansion under the health care law." (Ricardo Alonson-Zaldivar, "Health Care Spending To Accelerate, U.S. Report Says," The Associated Press, 7/28/15)

Health Care Spending Is Projected To Rise From "17.4 Percent In 2013 To 19.6 Percent In 2014, … Accounting For Nearly $1 Of Every $5 Spent." "Health care as a share of the nation's overall economy is projected to grow from 17.4 percent in 2013 to 19.6 percent in 2024, the report says, accounting for nearly $1 of every $5 spent." (Ricardo Alonson-Zaldivar, "Health Care Spending To Accelerate, U.S. Report Says," The Associated Press, 7/28/15)

ObamaCare Continues To Be A Drain On The U.S. Economy Through Higher Taxes And A Reduction In The Labor Force

The Nonpartisan Congressional Budget Office (CBO): ObamaCare Will "Raise Effective Tax Rates On Earnings And Thus Reduce The Amount Of Labor That Some Workers Choose To Supply." "The ACA will also affect the labor market in coming years and therefore affect output. The largest impact of the ACA on the labor market, especially as slack diminishes, will be that some provisions of the act raise effective tax rates on earnings and thus reduce the amount of labor that some workers choose to supply." ("The Budget And Economic Outlook: 2015 To 2025," Congressional Budget Office, 1/26/15)

  • CBO: ObamaCare Reduces Labor As The Law "Directly Imposes Higher Taxes On Labor Income Of The People." "That effect occurs partly because the health insurance subsidies that the act provides through the Medicaid expansion and the exchanges are phased out for people with higher income, creating an implicit tax on additional earnings by some people, and partly because the act directly imposes higher taxes on the labor income of other people." ("The Budget And Economic Outlook: 2015 To 2025," Congressional Budget Office, 1/26/15)

CBO: "Certain Aspects Of" ObamaCare Will "Lower The Participation Rate In The Next Several Years." "The rate of labor force participation has dropped noticeably in recent years, and CBO expects the rate to continue to decline-by about one half of one percentage point (to 62.5 percent) by the end of 2017 and by an additional one-half of one percentage point (to 62 percent) by 2019. A number of factors will dampen participation. The most important is the ongoing movement of the baby-boom generation into retirement. Federal tax and spending policies-in particular, certain aspects of the ACA, and also the structure of the tax code, whereby rising income pushes some people into higher tax brackets-will also tend to lower the participation rate in the next several years." ("The Budget And Economic Outlook: 2015 To 2025," Congressional Budget Office, 1/26/15)

CBO: ObamaCare Will Lead To The "Permanent Withdrawal Of Some Workers From The Labor Force." "The remainder stems from the reduction in some people's incentive to work resulting from the ACA and the structure of the tax code and from the permanent withdrawal of some workers from the labor force in response to the recession and slow recovery." ("The Budget And Economic Outlook: 2015 To 2025," Congressional Budget Office, 1/26/15)


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