Obamacare's Other Provisions Still Hurting Americans: Premiums Going Up, Networks Narrowing, Physician Shortages Expected, Info Lacking For Patients

Today in Washington, D.C. - June 30, 2014
Today the Supreme Court released their decision in Burwell v. Hobby Lobby. The issue in the Supreme Court case is that the Obama Administration is trying to force Hobby Lobby's owners to provide abortion-inducing products that violate their religious beliefs. Hobby Lobby's owners are not demanding that those products be banned or that anyone (including employees or customers) be prohibited from buying or using them. Hobby Lobby's owners just do not want to insure items that violate their religious beliefs.

In a 5-4 decision, the court ruled that the Obamacare contraception mandate violates protections for freedom of conscience. Hobby Lobby's owners will not have to choose between their business and their faith. The Hobby Lobby decision is narrowly tailored to the particulars of this case, and does not dismiss the idea that the government has a fundamental compelling interest in mandating abortion coverage.

The Senate at noon held a pro forma session & will do so again on Thursday at 1:30 PM. Senate will will return for legislative business on Monday, July 7th.

The House at 11:30 held a pro-form session. They will hold another pro-forma meeting at Noon on July 3, 2014. The House will return to take up legislative action on July 8th.

Reacting to the Supreme Court’s decision ruling in favor of Hobby Lobby’s challenge to an Obamacare mandate, Senate Republican Leader Mitch McConnell said, “Today’s Supreme Court decision makes clear that the Obama administration cannot trample on the religious freedoms that Americans hold dear. Obamacare is the single worst piece of legislation to pass in the last 50 years, and I was glad to see the Supreme Court agree that this particular Obamacare mandate violates the Religious Freedom Restoration Act (RFRA).”

Unfortunately, the many other provisions in the unpopular health care law continue to support Leader McConnell’s statement that “Obamacare is the single worst piece of legislation to pass in the last 50 years.” Bloomberg News noted last week in an article titled “Obamacare Premiums Are Going Up—Here's Why” that “[p]remiums are expected to rise in eight of the nine states where insurers have submitted 2015 rates for approval.”

Obamacare plans themselves continue to suffer from confusion, bad information, and red tape. The Los Angeles Times reported yesterday that “[m]ore complaints are surfacing as patients start to use their new coverage bought through Covered California, the state's health insurance exchange. ‘I thought I had done everything right, and it's been awful,’ said Jean Buchanan, 56. The Fullerton resident found herself stuck with an $8,000 bill for cancer treatment after receiving conflicting information on whether it was covered. ‘How am I going to come up with that much money?’ Insurers insist that pruning the network of doctors is a crucial cost-cutting measure . . . . ‘These narrow networks are making a huge difference in terms of affordability,’ said Mark Morgan, president of Anthem Blue Cross, a unit of industry giant WellPoint Inc.” In another example, the Times writes of “Tom DiCioccio, 64, of Oceanside [who] faced a similar predicament after getting diagnosed with cancer in his lymph nodes. The retired shoe designer owes nearly $20,000 for his cancer surgery this year after Blue Shield switched him into a policy with fewer providers. The insurer covered his care at Cedars-Sinai Medical Center on his prior plan, and he said Blue Shield never advised him of any major changes. Like many consumers, he said it was nearly impossible to get information from the company's call center or website.”

According to the LA Times, “Nationwide, about half of all exchange plans feature narrow networks, according to consulting firm McKinsey & Co., which has closely tracked the new insurance market. In forming tighter networks, insurers tried to persuade doctors and hospitals to accept less money in exchange for a higher volume of Obamacare patients. Los Angeles pediatrician Danelle Fisher said she couldn't afford the 30% pay cut offered by Blue Shield. She would have received $68 instead of $97 for a routine office visit for a patient with a PPO policy. Fisher decided she could not accept Covered California insurance but thought other Blue Shield patients would not be affected — a common misperception among doctors and patients. Blue Shield's new terms also applied to patients with individual policies outside the exchange.”

On top of all this, USA Today reports, “Federally funded programs will add at least 2,300 new primary care practitioners by the end of 2015, but the funding for at least one of those programs is set to expire at the same time, contributing to a massive shortage of doctors available to treat patients — including those newly insured through the Affordable Care Act and Medicare. The U.S. is expected to need 52,000 more primary care physicians by 2025, according to a study by the Robert Graham Center, which does family medicine policy research. But funding for teaching hospitals that could train thousands more of these doctors expires in late 2015. Population growth will drive most of the need for family care doctors, accounting for 33,000 additional physicians, the study says. The aging population will require about 10,000 more. The Affordable Care Act is expected to increase the number of family doctors needed by more than 8,000, the study says.”

Meanwhile, insurance companies are finding other predictable but unfortunate outcomes to Obamacare. The Wall Street Journal reported last week, “People enrolled in new plans under the health law are showing higher rates of serious health conditions than other insurance customers, according to an early analysis of medical claims, putting pressure on insurers around the country as they prepare to propose rates for next year. Among those health-law marketplace enrollees who have seen a doctor or other health-care provider in the first quarter of this year, around 27% have significant health issues such as diabetes, psychiatric conditions, asthma, heart problems or cancer, the data show. That is sharply higher than the rate of 16% for last year's individual-consumer market over the same time frame, according to the data, which was supplied by Inovalon Inc., a health-technology firm that receives medical claims directly from nearly 200 insurers that are its clients. . . . The findings provide the clearest picture so far of the health status of those who bought plans under the Affordable Care Act, and show a sharply bifurcated consumer insurance market—with sicker, and costlier, people in health-law plans and healthier people sticking with previous coverage. Insurers say that dynamic could drive up premiums for many health-law plans next year, because the Obama administration recently announced that it would allow the grandfathered coverage to linger into 2016, if states and insurers choose. . . . The rate of documented health conditions is ‘a good leading indicator of where medical costs are going,’ said Dan Rizzo, Inovalon's chief innovation officer. Though insurers don't yet have a complete picture of enrollees' health, Mr. Rizzo said the firm believed the 16 states provide a ‘representative mix of the experience of health plans’ nationally. . . . [S]ome insurers say enrollees so far appear less healthy than they had projected. ‘It's even worse than what we thought,’ said Patrick Getzen, chief actuary for Blue Cross & Blue Shield of North Carolina. ‘We're seeing more chronic conditions than we would have expected,’ he said, and that will ‘put pressure on the 2015 rates.’”

And The Washington Post, pointing to a report from “a trio of academics from the University of Pennsylvania,” writes that it “shows that women age 55 to 64 will face a huge spike in cost when they go out to buy individual insurance on the federal exchange. These women bear the brunt of the increased premiums and out of pocket expenses after the Affordable Care Act. . . . After crunching the numbers, they found that people who buy the bronze or silver plans on the federal exchanges will spend a moderate amount more . . . on premiums and out of pocket expenses than they did before the health reform took effect. However, that average figure masks a huge redistribution of the costs to older women from nearly everyone else. Total expected premiums and out of pocket expenses rose by 50 percent for women age 55 to 64 — a much larger increase than for any other group — for policies on the federal exchanges relative to prices that individuals who bought individual insurance before health care reform went into effect. . . . ‘It’s likely because they are being averaged in with younger women who have much higher expenses associated with childbearing and with older men who didn’t take care of themselves. Community rating redistributes against the relatively healthy,’ [Mark Pauly, one of the authors of the study] explained.”

Obamacare is a mess. It has taken existing problems with the American medical system and exacerbated them while inserting ever more government bureaucracy and red tape. Premiums are going up, Americans are facing smaller networks of providers, and information about those networks is more difficult to come by, leading to confusion and uncovered medical expenses. Doctors and hospitals are being reimbursed less, forcing them to accept fewer patients and insurance plans and there won’t be enough of them to meet the greater demand created by a growing and aging population and the incentives created by Obamacare. The mix of patients in Obamacare plans is skewing towards those needing more care, which will again drive premiums up and the regulations in Obamacare are forcing many healthier people to pay much more, including older women.

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