Posts Tagged ‘Obamacare’
Problem number one for the healthcare law is that the federal government is far behind schedule in developing insurance exchanges for small businesses — so far behind that the exchanges have been delayed an entire year.
“Lots of small businesses struggle with providing insurance for their workers so this was supposed to facilitate it and make it easier for small business to do this,” Jim Capretta of the Ethics and Public Policy Center told Angle. “It was a huge portion of the sale job. When they passed the law in 2010 there were many senators and members of Congress who were saying ‘I am doing this because it’s going to help small businesses.’”
If so, it’s not going to help them until 2015 at the earliest. In the meantime, what was supposed to be a variety of coverage options for small-business employees will now be just one choice — which, of course, isn’t a choice at all. This “could mean they can’t shop for insurance that includes their current providers,” Angle notes. So much for President Barack Obama’s promise that people who like their insurance plans will be able to keep them under his healthcare law.
On top of that, state insurance exchanges, which are supposed to make it easier for people to purchase coverage on the individual market, are scheduled to open in 2014. Since many small businesses are exempt from ObamaCare’s employer mandate because they have fewer than 50 employees, Angle writes, “analysts now fear many might just stop trying [to insure their employees] and let workers go on the … state exchanges.”
That assumes that the state exchanges will be up and running next January. States have not exactly rushed to set them up. In fact, more than half — 26, to be exact — have chosen not to do so, placing the burden of establishing their exchanges squarely on Uncle Sam.
Because so many states have opted out of creating their own exchanges, “it is looking increasingly as if the Administration has painted itself into a corner,” columnist Joseph Totah maintains. The Obama administration, he says, “is having tremendous difficulties creating the massive information technology backbone required for their insurance exchanges to work. Current estimates are that they are running at least three months behind an already tight time schedule just trying to write software. That’s hanging up everyone waiting on the Feds to come up with their solution, because the states still have to make it work.”
The second major problem for ObamaCare is the new 2.3-percent excise tax on medical devices. The tax was supposed to help pay for the law’s insurance subsidies, but it is proving so onerous that even Democrats want to repeal it.
It would be bad enough if the tax were on the profits from device sales. This one, however, is “a tax on gross sales — meaning it adds up to a much bigger percentage of a company’s profits,” according to Angle. In fact, because the tax is levied on gross sales rather than profits, “many companies will owe more in taxes than they generate from their operations,” Mark Perry of DailyMarkets.com avers. “The result will be devastating to innovation, patient care and job creation.”
Read More: http://thenewamerican.com/
Read more: http://MinuteMenNews.com/2013/04/obamas-party-seeking-to-save-its-own-skin-as-obamacare-crumbles/#ixzz2PgakLsY1
Today the NY Times has a case study on the cost of Obamacare to one small business. The business in question is Baked in the Sun, a California baker with 95 employees. Baked in the Sun does about $8 million in annual revenue, however margins for bakers are tight so their annual profit is only about $200,000. Because the business has over 50 employees, they will be required to offer health insurance to their employees or pay a fine for not doing so. The owners estimate that the cost of compliance would be $108,000 per year plus $10,000 in overhead to manage the plan. The cost of paying the fine for not offering insurance would be $130,000. So they have a choice between losing 64% or 65% of their annual profits. The article goes on to note that not all employees will take the insurance being offered. Some will already have it through another individual–a spouse or parent. So the actual cost of offering a plan will likely be less than the potential cost. Of course, no one knows what the plans themselves will cost yet so it’s all a guess at this point. In any case, just a week ago Five Guys burgers announced the cost of Obamacare compliance was going to force them to raise prices. Matt Yglesias, who writes for Slate, was quick to call them “whiners.” Obamacare is going to reduce his profits by about one-eighth and he (and any investors in his business) will eat the loss. With corporate profits as a share of the economy at an all-time high, nobody’s going to cry for him either. In other words, eat the 1/8 loss of profits and shut up about it. But unlike Five Guys, Baked in the Sun facing a loss of up to 2/3 of their annual profits, meaning they will almost certainly be forced to raise prices:
Despite surviving a number of threats, President Obama’s health care law remains harmful, unstable, and unpopular. It also remains vulnerable to repeal, largely because Congress and the Supreme Court have granted each state the power to veto major provisions of the law before they take effect in 2014.
The Patient Protection and Affordable Care Act (PPACA) itself empowers states to block the employer mandate, to exempt many of their low- and middle-income taxpayers from the individual mandate, and to reduce federal deficit spending, simply by not establishing a health insurance “exchange.” Supporters of the law do not care for this feature, yet they adopted it because they had no choice. The bill would not have become law without it.
To date, 34 states, accounting for roughly two-thirds of the U.S. population, have refused to create Exchanges. Under the statute, this shields employers in those states from a $2,000 per worker tax that will apply in states that are creating Exchanges (e.g., California, Colorado, New York). Those 34 states have exempted at least 8 million residents from taxes as high as $2,085 on families of four earning as little as $24,000. They have also reduced federal deficits by hundreds of billions of dollars.
The Obama administration is nevertheless attempting to tax those employers and individuals, contrary to the plain language of the PPACA and congressional intent, and to deny millions of Americans the opportunity to purchase low-cost, high-deductible coverage. Employers, consumers, and even state officials in those 34 states can challenge those illegal taxes in court, as Oklahoma has done. States can also block those illegal taxes—and even stop the federal government from operating an Exchange—by approving a strengthened version of the Health Care Freedom Act.
The PPACA’s Medicaid expansion, which would cost individual states up to $53 billion over its first 10 years, is now optional for states, thanks to the Supreme Court’s ruling in NFIB v. Sebelius. Some 16 states have announced they will not expand their programs, while half of the states remain undecided. Yet the Obama administration is trying to coerce states into implementing parts of the expansion that the Court rendered optional. States can replicate Maine’s lawsuit challenging this arbitrary attempt to limit the Court’s ruling.
Collectively, states can shield all employers and at least 12 million taxpayers from the law’s new taxes, and still reduce federal deficits by $1.7 trillion, simply by refusing to establish Exchanges or expand Medicaid.
Congress and President Obama have already repealed the third new entitlement program the PPACA created—the Community Living Assistance Services and Supports Act, or CLASS Act—as well as funding for the “co-op” plans meant to serve as an alternative to a “public option.” A critical mass of states exercising their vetoes over Exchanges and the Medicaid expansion can force Congress to reconsider, and hopefully repeal, the rest of this counterproductive law. Real health care reform is impossible until that happens.
Things aren’t going so well for Obamacare.
Even Democrats in Congress aren’t huge fans any more. It seems after passing the law and finding out what’s in it, the allure has faded—so much so that Congress actually repealed part of Obamacare in the fiscal cliff deal last week.
That’s right—part of Obamacare has been completely undone. It was the Community Living Assistance Services and Supports (CLASS) Act, essentially a new entitlement program for long-term care. But this new government program for people who end up needing assisted living or other long-term services was poorly designed and bound to fail, as Heritage’s Alyene Senger explains.
“CLASS was a bad deal for both taxpayers (who would likely have had to bail out the program) and beneficiaries (who would be better served by choosing among private options),” Senger wrote.
The program was so poorly designed that one of its own administrators warned Congress in 2011 that the program could collapse.
This is just one example of how poorly thought out Obamacare was—but this example so captured Congress’s attention that it spurred action. Another part of Obamacare that just took effect, the medical device tax, started making some Senators uneasy before it was scheduled to begin.
A group of 18 Senators, including such outspoken Democrats as Al Franken (MN), John Kerry (MA), Charles Schumer (NY), and Debbie Stabenow (MI), asked Majority Leader Harry Reid (D-NV) to delay the tax, which falls on every item used in medical treatments, from stents to syringes, IV tubes, and prosthetics.
As Heritage senior policy analyst Curtis Dubay noted, this tax will mean more than just higher prices:
Depending on how these businesses pass the tax on, it could result in higher prices for their customers (e.g. patients), lower returns to their shareholders, or fewer jobs for their workers. As we explained earlier, evidence is mounting that it is their workers that will bear the brunt of the tax.
More taxes, higher prices, and lost jobs—no wonder the Senators wanted to delay it! If only they had considered those effects before many of them voted for Obamacare in the first place.
The medical device tax is only one of five of the new taxes that start in 2013 and one of the 18 tax hikes spread throughout Obamacare. Many of these tax hikes, like the medical device tax, will hit hard-working Americans.
Even Democratic governors are unsure about this law. Many governors are weighing the costs of setting up a state health exchange and expanding their already troubled Medicaid programs. The nation’s governors, like the U.S. Congress, are figuring out that Obamacare is an unworkable monstrosity.
Senate Majority Leader Harry Reid (D-NV) said Hurricane Katrina was “nothing in comparison to what happened to the people in New York and New Jersey” from Hurricane Sandy. Katrina killed 1,833 people compared to 120 deaths from Sandy.
“President Barack Obama on Monday will nominate Chuck Hagel as his next defense secretary and counterterrorism adviser John Brennan to lead the Central Intelligence Agency,” reports the Associated Press.
Representative Nancy Pelosi (D-CA) said yesterday that President Obama should disregard Congress and deem the debt limit unconstitutional.
What is the story of income inequality—and economic mobility? Can you improve your standard of living? Heritage’s Stuart Butler, director of the Center for Policy Innovation, answers.
In this new video, watch Heritage’s president-elect, Senator Jim DeMint, talk about growing up in Greenville, S.C., as the son of a single mom.
Tucked inside the “fiscal cliff” deal is a provision repealing the CLASS Act, a giant unfunded mandate that was part of President Obama’s health care law.
The Community Living Assistance Services and Supports program was a priority of the late Sen. Edward M. Kennedy, Massachusetts Democrat, and was designed to create a program for long-term care for the functionally disabled.
Mr. Obama halted the program, saying he couldn’t find a way to make it cost-effective. But he had objected when Republicans tried to repeal it outright, saying he wanted to keep it on the books and try to amend it rather than kill it.
But he did an about-face this week, accepting repeal in exchange for raising tax rates on the wealthiest.
Mr. Obama also won a new commission to look at long-term care. The commission is supposed to come back and report on ways to boost health coverage for those the CLASS program was designed to reach.
The cliff deal passed the Senate 89-8 early Tuesday morning and was awaiting a vote in the House later in the day.
Read more: http://www.washingtontimes.com/blog/inside-politics/2013/jan/1/fiscal-cliff-deal-repeals-part-obamacare/#ixzz2GvGy9ECi
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As the Affordable Care Act is in full swing, there’s a lot of apprehension and perhaps, sometimes, enthusiasm about what is truly in store for the medical profession.
The last time you visited your doctor you may have noticed that he or she was more apprehensive, cautious, and yes, maybe more overwhelmed. The fact of the matter is that the health care profession is undergoing the most significant renovation to ever happened in the history of the United States.
Here are many things that keep many doctors awake at night:
1. A new wave of new patients.
Now that insurance companies must accept people with pre-existing conditions, and dependents under the age of 26, there is a new floodgate that has opened, which will bring more people into the system to see a primary care physician. In addition, many states will be expanding their Medicaid rosters, which will also introduce a greater volume of patients all competing for a limited number of physicians.
The projected shortage in primary care physicians between now and the year 2020 is expected to exceed 90,000 by some estimates, which means we have a real supply and demand issue. Either physicians will have to extend their hours and see more patients, or patients will have to wait longer to get an appointment.
2. The paycheck could start shrinking.
Although one would think that a rise in patient volume would correlate into higher income, reimbursements for many specialties could, in fact, be reduced under ObamaCare. There are proposed cuts of almost $718 billion out of Medicare, which will be based on reduced reimbursements and reduction in fraud and waste in the health care system. There is no question that there is room for improvement in reducing the number of unnecessary or duplicate tests being done, but the real concern for doctors is a lot of these decisions will be made by IPAB, the Independent Payment Advisory Board, which will dictate the standards.
3. The wonders of technology.
Every physician is now required to implement an electronic medical record as a means of standardizing information gathering and sharing in the health care industry. This is a good idea. The problem is that in order for a physician to effectively implement a new system, they need to cancel patients for a few months in order to accommodate the transition in learning, which in turn, creates a backlog.
There is, of course, the cost of implementing a new system that will eat into the profits a doctor already earns (and is potentially diminishing). Doctors may even need to hire newly skilled staff to manage these systems and convert their manual records to an electronic one. Technology is important, but the road to success will be rocky.
4. Decreased face time.
With a increasing volume of patients and increased demands on technology and reduced reimbursement, what might ultimately happen is that patients spend less time with their doctor – less than even the average seven minutes. The domino effect from here is that patients get less questions answered, and doctors are more exposed to missing things in the process. In addition, there is the likelihood this could lead to more tests being ordered because there is simply no time to take a good history that is often the crux of an accurate diagnosis.
5. Staying connected.
A major part of the new delivery system is accountable care organizations, which are designed to improve coordination between doctors, hospitals, patients and care takers. Many doctors will soon be reimbursed through a bundled fee for the services that are delivered for an individual for all of the doctors responsible. It will now be critical that doctors are able to understand what tests and evaluations were done before and after a patient’s visit in order to best be able to coordinate care.
Hospitals will be penalized if patients come back within a certain period of time, and it will be very important for them to be able to communicate with the primary care doctors to make sure the patient complies with their appointments, medications and any other care.
7. The doctor-patient relationship.
As insurance companies try to get more market share, many of them are buying up doctors’ practices and aligning themselves with hospitals to create a monopoly. This is not very different from the days of managed care. Most of us are used to physician choice, and there is nothing more special than the relationship with our doctor. The trend remains that with future consolidation of the market, many doctors could be excluded from certain networks , and you may no longer be able to see the doctor of your choice.
The years 2013 and 2014 will be big years for the health care profession and the next time you visit your doctor, you might put these points into perspective, as this might ultimately impact the future of your care.
Dr. Sreedhar Potarazu is an acclaimed ophthalmologist and entrepreneur who has been recognized as an international visionary in the business of medicine and health information technology. He is the founder of VitalSpring Technologies Inc., a privately held enterprise software company focused on providing employers with applications to empower them to become more sophisticated purchasers of health care. Dr Potarazu recently founded GoodChime! a social platform for driving consumer engagement in health for which he is the chairman.
Read more: http://www.foxnews.com/health/2012/12/04/7-things-that-scare-your-doctor/#ixzz2ENgTZ5kJ