Health Care Policy

Top Reasons To Study Medicine

Interested to study medicine? This is the top reason why you are interested in studying medicine. The top reason is the result of a survey of medical students in America. 1. Plenty of opportunities upon graduating This reason is rarely stressed properly, but it truly is so. After gradutation there is a broad range of opportunities for future job. In case you find none of the possibilities appealing, you can combine them or invent your own......

Urging Patience, Obama Says Problems With Health Care Sites Reflect Demand

Report from The New York Times, President Obama urged Americans who have flocked to the new government-run Web marketplaces for health insurance policies not to give up because of the technical problems attributed to greater-than-anticipated demand. Fixes are under way, he said. Mr. Obama, in an interview with The Associated Press released on Saturday, said he did not have any figures to counter scattered reports that just a very small number of people have succeeded in signing up for insurance coverage since state and federal Web sites began enrollment on Tuesday for the so-called insurance......

10 ways to get ready for the Health Insurance Marketplace

Open enrollment in the Health Insurance Marketplace is coming soon. Here’s how you can get ready to enroll starting October 1, 2013. Find the Marketplace in your state and get your options & info. Sign up for email or text updates about the Marketplace and connect with us on social media. Gather basic information about your household income to see if you qualify for lower costs on Marketplace coverage. Use this checklist to get started. Set your budget and estimate your costs and savings in the Marketplace. Make sure you understand how coverage works, including things like premiums,......

The Affordable Health Care Act's Launch On October 1st––So How Did it Go?

Unavoidably, that will be the big question come Tuesday.But there will be much more to it than that.A 180-Day Open Enrollment––Not a One-Day Open EnrollmentWhat happens on the first day, for good or bad, will constitute only a tiny percentage of the open enrollment period. Consumers will likely visit the new websites many times before they make any decisions, and that is exactly as it sho......

Benefit Shock? Consumers Will Be Surrpised By What They Find on the New "Obamacare" Health Insurance Exchanges

Will we have rate shock?It looks to me like consumers will have a choice when they get to look at the health plans available on the new "Obamacare" health insurance exchanges––rate shock or benefit shock. While there has been lots of focus on the issue of rate shock, I will suggest that just as big an issue may well be benefit shock—that consumers will look at what they will be getting for......

So If the Maryland Health Insurance Rates Are So Cheap Why Did I Get This Postcard From Maryland Blue Cross?

That's what I wondered when I got this postcard; presumably sent to lots of people who live in Maryland:In it, (click on card to enlarge) Maryland Blue Cross is telling me that; "I am invited to obtain a [health] plan right now with rates that may be significantly lower than reform-compliant plans [their emphasis]."Are they suggesting there is rate shock coming? I was surprised to get this......

Oregon Delays Key Element of Insurance Exchange––Good for Them!

Five years from now no one will remember if their "Obamacare" health insurance exchange launched on October 1. The state-run Oregon health insurance exchange, Cover Oregon, recently announced it will be delaying web access to the its new "Obamacare" health insurance offerings two to four weeks later than the scheduled October 1 launch date.People will be able to begin signing up for health......

"ObamaCare" Small Ball––The Republicans Are Winning the Battle Over the Big Idea

Last week the President waded directly into the national debate over "ObamaCare" by calling a big media event in the East Room of the White House to talk about the $100 rebates a small percentage of potentially eligible people are getting under the new health law.Senate Republican Leader Mitch McConnell countered, "If you’re a family in Covington facing a $2,100 premium increase under......

People Who Haven't Filed a Tax Return to Get Unverified Health Insurance Exchange Subsidies

The head of the Centers for Medicare and Medicaid, Marilyn Tavenner, is out with a "Myths vs. Fact" clarification memo regarding the waiver of the employer mandate and whether the new health insurance exchanges will verify people's incomes when calculating subsidies.I noted a couple of things in her memo.Her memo indicates that the exchanges will request additional income information from a......

Health Insurance Exchange Subsidies Will Be Granted on the Honor System!––Is There Something Wrong With "ObamaCare's" Federal Data Hub?

Come October millions of people will be applying for tens of billions of dollars in federal health insurance premium subsidies on the honor system.On the Friday after the Fourth of July––when the administration apparently hoped no one would be paying attention––the Obama administration dropped 606 pages of regulations. Buried inside was the news that that insurance exchanges can ignore any......

Administration Delays the Employer Mandate––But What About Small Employers?

The administration suddenly announced tonight that the requirement that all employers with 50 or more workers offer health insurance has been delayed until 2015.If an employer with 50 or more workers did not provide health insurance to their full time workers in 2014, they would have been subject to a fine of $2,000 per worker. The employer would have also been subject to a $3,000 fine for e......

Will the Affordable Care Act's ("ObamaCare") Federal Health Insurance Exchanges Be Ready On Time? Finally the Facts!

After months of speculation on just where the Obama administration is toward the development of the new health insurance exchanges, the Government Accountability Office (GAO) has issued a 48-page report complete with timelines and a detailed report on just where the Obama administration is––or at least was last month.The key summary:"Much progress has been made, but much remains ......

Will the Affordable Care Act's Health Insurance Exchanges Be Ready On Time? The Obama Administration's Top Secret Enterprise

Last week, I received my weekly email update from the Maryland health insurance exchange:Maryland Health Connection completed its Final Detailed Design Review (FDDR) live system demo on Thursday, May 30. The FDDR is a federal stage-gate required of all state-based exchanges. Maryland Health Connection successfully demonstrated end-to-end enrollment of a split family scenario including user......

Flawed Analysis––Medical Loss Ratio Rules Led to $1.9 billion in Lower Premiums

The Kaiser Family Foundation is out with a study contending that the Medical Loss Ratio (MLR) requirements of the Affordable Care Act ("ObamaCare") saved consumers $1.9 billion in premiums in 2012:"So how might these (new MLR requirements) changes have affected premiums? As noted above, one way to address this question is to compute what these consumers would have paid in premiums in 2011 and......

Rate Shock in California!––The New Health Insurance Exchange Plans––Comparing Apples to Oranges to Grapefruit

I have to say I was surprised with the press reports last week that there wasn't "rate shock" in California when the California exchange offered preliminary information about their new plans and rates.At least one prominent health actuarial group had predicted a 30% baseline increase in costs for California's new health insurance exchange plans under the Affordable Care Act (ObamaCare").As......

A Health Insurance Exchange That Won't Be a "Train Wreck"

Every week, I get an email from the Maryland Health Connection––the state run health insurance exchange.Maryland is one of a minority of states that are building their own Affordable Care Act ("ObamaCare") exchange.You can go to their site and sign up for these weekly updates.Let me suggest that Maryland is an example of what an on-track and well organized effort looks like for any excha......

Implementation of the Affordable Care Act––More Evidence That Rate Shock is Coming

The Society of Actuaries is out with another estimate of health insurance rate increases as a result of implementation of the Affordable Care Act ("Obamacare").While there is a great deal of difference between states, they are estimating an average increase of 31.5% on account of the new underwriting reform and benefit expansion requirements of the health law:These rate increase......

Six Months to Go –– Will the Health Insurance Exchanges Be Ready on Time? Survey: Health Plan Execs Don't Think So

As the Obama administration continues its top secret effort to build federal insurance exchanges in about 34 states while 16 states are doing it on their own, that continues to be the big question.HHS is using IT consulting firm CGI for much of the work on the exchanges and the federal data hub. CGI has their plate full since they are not only working on the federal exchange but also doing w......

The Cost to Launch the California Health Insurance Exchange is $910 million––Does That Sound Like a Lot to You?

So far California has received $910 million in federal grants to launch its new health insurance exchange under the Affordable Care Act ("Obamacare").The California exchange, "Covered California," has so far awarded a $183 million contract to Accenture to build the website, enrollment, and eligibility system and another $174 million to operate the exchange for four years.The state will also......

Christie Removes Another Republican Excuse for Passing on the Medicaid Expansion

The New Jersey Governor became the eighth Republican to take the Medicaid expansion deal.What I found notable is that he essentially mimicked Florida Republican Governor Rick Scott in reserving the right to back out in future years if the feds don't keep their funding promises. While the feds are paying 100% of the cost of expansion in the first three years, that support ultimately drops to ......

C. Everett Koop, MD

Anyone who has ever read this blog and noticed its upper right hand corner has known that Dr. Koop and I were friends––for more than 20 years.One of my more amazing experiences with Dr. Koop centers on a walk we took from the White House to my office up Connecticut Avenue. In the length of about a mile, I don't know how many people stopped him and thanked him for his service. Just regular......

Florida's Republican Governor Scott Does a Deal With Sebelius on Medicaid

A million Floridians will now be eligible for Medicaid––the Obama administration is happy about that.Republican Rick Scott gets to do it his way––in an almost entirely private market.This from today's Tampa Bay Times:His [Scott's] endorsement of the expansion came hours after the federal government agreed to grant Florida a conditional waiver to privatize Medicaid statewide for the stat......

By Refusing to Implement the Medicaid Expansion Republican Governors May Be Making the Republican Block Grant Proposals Impractical

Paul Ryan's Medicaid block grant proposals have always made sense to me. Give the states their Medicaid allotment and real flexibility over how they spend what will inevitably be less federal money.But as I have thought about the impact of implementing the Medicaid expansion under the Affordable Care Act ("Obamacare"), Medicaid block granting is looking more and more problematic.Under the new......

One Fiscal Cliff Down and Three To Go––But No Real Solution On the Horizon

Last week's deal to avert the "fiscal cliff" settled very little.For those in the health care market, I will suggest the big takeaway is that we should expect very little will be settled in the coming months and we will continue to face a great deal of uncertainty for years to come.Without an agreement to alter the course we are on, it is estimated that we will add more than $10 trillion to......