House Republicans won Round 2 in a potentially historic lawsuit Thursday when a federal judge declared the Obama administration was unconstitutionally spending money to subsidize health insurers without obtaining an appropriation from Congress.
Last year, U.S. District Court Judge Rosemary Collyer broke new ground by ruling the GOP-controlled House of Representatives had legal standing to sue the president over how he was enforcing his signature healthcare law.
On Thursday, she ruled the administration is violating a provision of the law by paying promised reimbursements to health insurers who provide coverage at reduced costs to low-income Americans.
The judge’s ruling, while a setback for the administration, was put on hold immediately and stands a good chance of being overturned on appeal.
A mid rising drug and health care costs and roiling market dynamics, the spokesperson for the nation’s health insurers is predicting substantial increases next year in Obamacare premiums and related costs.
Without venturing a specific percentage increase, Marilyn Tavenner, the president and CEO of America’s Health Insurance Plans (AHIP), said in an interview with Morning Consult that the culmination of market shifts and rising health care costs will force stark increases in health insurance rates in the coming year.
“I’ve been asked, what are the premiums going to look like?” she said. “I don’t know because it also varies by state, market, even within markets. But I think the overall trend is going to be higher than we saw previous years. That’s my big prediction.”
If Tavenner is right, Obamacare will jump dramatically—last year’s premium for the popular silver-level plan surged 11 percent on average. Although Tavenner didn’t mention deductibles, in 2016, some states saw jumps of 76 percent, while the average deductible for a 27-year-old male on a silver plan was 8 percent.
UnitedHealth, the nation’s biggest health insurer, will cut its participation in public health insurance exchanges to only a handful of states next year after expanding to nearly three dozen for this year.
CEO Stephen Hemsley said Tuesday that the company expects losses from its exchange business to total more than $1 billion for this year and last. He added that the company cannot continue to broadly serve the market created by the Affordable Care Act’s coverage expansion due partly to the higher risk that comes with its customers.
The state-based exchanges are a key element behind the Affordable Care Act’s push to expand insurance coverage. But insurers have struggled with higher than expected claims from that business.
UnitedHealth Group Inc. said it now expects to lose $650 million this year on its exchange business, up from its previous projection for $525 million. The insurer lost $475 million in 2015, a spokesman said.
It should have been a prideful occasion. Dr. Adam Jarrett, who was in the very first class of residents at New York Hospital-Cornell Medical School in 1992 to train in a new program focusing on primary care, was recently invited back to his alma mater.
The plan by New Jersey’s largest insurance company to divide hospitals into two tiers has already angered customers and health care providers and now it has split Democratic lawmakers as the Legislature considers bills to review the move. John C. Ensslin, The Record Read more
” I hope you haven’t been making plans of what to do with that $2,500 a year you’ll be saving on premiums. The NPR poll confirms that that was just another in Obama’s litany of lies. Forty-five percent of respondents said their premiums had gone up, while 46% said their premiums had stayed about the same. Only 4% said their premiums had actually gone down, as Obama promised they would.” Alieta Eck, MD
In Health Care, Politics by Mr. RightMarch 4, 20162 Comments
Most of the country now knows what we were warning about several years ago: Obamacare is horrible. Even the far-left folks at NPR were made aware of it when one of their own polls showed that only 15% of Americans say they have been helped by the law.
From American Thinker:
A thorough repudiation of the (un-)Affordable Care Act comes from, of all places, state-run National Public Radio. Timed to be buried by Super Tuesday coverage, NPR this week released a new study that indicates that Obamacare has failed on almost all levels.
The poll, by NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health, shows that three quarters of Americans think health care in their state has not improved under Obamacare. The survey says more people think health care has gotten worse (26%) than better (15%). Forty-nine percent of people think health care has stayed about the same.
And I hope you haven’t been making plans of what to do with that $2,500 a year you’ll be saving on premiums. The NPR poll confirms that that was just another in Obama’s litany of lies. Forty-five percent of respondents said their premiums had gone up, while 46% said their premiums had stayed about the same. Only 4% said their premiums had actually gone down, as Obama promised they would.
Along with higher premiums, co-pays and deductibles have gone up for 35% of people.
Read the Rest (give it a click. It’s good)
Yeah, America hates Obamacare. And you can probably guess how NPR reported on the poll results…
From Newsbusters:
This is not all the way NPR reported on its own poll. On Monday’s Morning Edition, they waited until late in a seven-minute segment to mention the Obamacare part of their results on health care, and they completely avoided numbers, especially the notion that more feel harmed than helped…
Sixteen months before the state’s largest insurer launched new health plans that steer patients to its preferred hospitals, called Tier 1, a report from its consultants spelled out how the Omnia health plan would work and what it would do to the state’s health care business.
Ridgewood NJ, Donald Trump releases his Healthcare Reform Plan , its time for other candidates to do the same .
“Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare. This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan President in American history, has tragically but predictably resulted in runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices. Obamacare has raised the economic uncertainty of every single person residing in this country. As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next President and a Republican congress lead the effort to bring much-needed free market reforms to the healthcare industry.
But none of these positive reforms can be accomplished without Obamacare repeal. On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare.
However, it is not enough to simply repeal this terrible legislation. We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country. By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.
Any reform effort must begin with Congress. Since Obamacare became law, conservative Republicans have been offering reforms that can be delivered individually or as part of more comprehensive reform efforts. In the remaining sections of this policy paper, several reforms will be offered that should be considered by Congress so that on the first day of the Trump Administration, we can start the process of restoring faith in government and economic liberty to the people.
Congress must act. Our elected representatives in the House and Senate must:
Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to.
Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up.
Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.
Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.
Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.
Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.
The reforms outlined above will lower healthcare costs for all Americans. They are simply a place to start. There are other reforms that might be considered if they serve to lower costs, remove uncertainty and provide financial security for all Americans. And we must also take actions in other policy areas to lower healthcare costs and burdens. Enforcing immigration laws, eliminating fraud and waste and energizing our economy will relieve the economic pressures felt by every American. It is the moral responsibility of a nation’s government to do what is best for the people and what is in the interest of securing the future of the nation.
Providing healthcare to illegal immigrants costs us some $11 billion annually. If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country, we could relieve healthcare cost pressures on state and local governments.
To reduce the number of individuals needing access to programs like Medicaid and Children’s Health Insurance Program we will need to install programs that grow the economy and bring capital and jobs back to America. The best social program has always been a job – and taking care of our economy will go a long way towards reducing our dependence on public health programs.
Finally, we need to reform our mental health programs and institutions in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support.
To reform healthcare in America, we need a President who has the leadership skills, will and courage to engage the American people and convince Congress to do what is best for the country. These straightforward reforms, along with many others I have proposed throughout my campaign, will ensure that together we will Make America Great Again.”
Just 15 percent of people say they have personally benefited from ObamaCare, although more than one-third believe it has helped the people of their state, according to a poll released Monday.
Most Americans — a total of 56 percent — say they haven’t felt directly affected by the Affordable Care Act. Among those who have felt affected, more people say the law has hurt them than helped them, according to polling by National Public Radio and the Robert Wood Johnson Foundation.
Twenty-six percent of U.S. adults say they have been personally harmed by the healthcare law since its passage — a fraction that likely reflects those in the poll who said they have noticed rising healthcare costs in the last several years.
Open Letter to Patients, Physicians, and Lawmakers
February 14, 2016 By Sharon Jellinek MD
This is the first letter I’ve ever written to a political figure and I pray that someone on your staff will bring this letter to your attention. I have been a physician for close to 30 years. I am a second-generation pediatrician struggling to keep an independent solo practice alive. Not one politician has addressed what I feel is the major threat to health care…the physician-patient relationship. Without this, there is no quality of care no matter what you do. Physician patient relationships require time with the patient.Most of my diagnosis is derived from my patient-parent interview and a “hands on exam” of the child. You cannot possibly read a cookbook of medical questions and treatments and have the same result. The current insurance treadmill model of primary care makes this impossible. There is a hemorrhaging exodus of well-trained physicians unwilling to jeopardize this patient relationship. Insurance companies are pushing the small man (or woman), like myself, out and replacing us with cheaper, less qualified “health care extenders” i.e. nurse practitioners, physician’s assistants, pharmacists, or whomever they can place in a white coat for less money. This is at the expense of the patient and the profit of the insurance company.
I have done everything by the book. During my 12 years of postgraduate training I earned a degree in chemistry and biology, a Masters degree in Microbiology, and MD degree from Georgetown University Medical School where I also completed my pediatric residency. I am board-certified and recertified. I have a spotless record and a loyal patient following. I am not saying this to fluff my feathers but to emphasize my dedication to my calling. It is not just a job to me. This is what I was meant to do, and I will only do it the correct way.
Coming from generations of physicians, I take my job very seriously. My father was also a pediatrician and started his office in the basement of our home. I know what quality care is, and what it is not. I grew up knowing that medicine can exist without the interference of insurance companies. At that time, people paid a fair price for an office visit and had catastrophic hospital coverage for hospitalization and procedures. (My father actually was the physician who saved John F. Kennedy’s son, John John. His name is Dr. Ira Seiler M.D. It is a true story accessible through the archives. He also attended John F. Kennedy’s inaugural ball and parade).
My father instilled in me a respect for the patient-physician relationship without which there is no quality care. Insurance companies have continued to decrease our payments knowing that we will need to see more patients in a shorter amount of time to make up for the decreasing reimbursement rates. You do not have time to foster a relationship. This may result in more medical mistakes but ultimately bring in more money to the pockets of the insurance company. This is a very dangerous game, and I have refused to play it. For that I have been threatened and penalized.
I am trying desperately to keep my small practice alive. I spend at least 30 minutes with each patient, they have access to me via my personal cell phone 24/7. I have no wait times, will always see a sick patient that day, try to avoid ER/Urgent Care visits by seeing the patient after hours myself ( to avoid medical mistakes since after hours clinics usually are not staffed by pediatricians and I end up correcting the mistakes at 3am for free anyway). Many times I’ll bring a chart home and research a condition and if I don’t know something I will find out. And for this I am listed as a physician that is not cost effective, or in other words I spend too much time per patient, which results in less revenue to the insurance company.
Medicine is not a 9-to-5 job, it is a calling and my greatest fear is that no one is going to want to do this job for a salary of $6000 a year, which after all my office expenses, I earned. And that is not from poor business skills or lack of patients. It is from decreasing reimbursement rates and higher overhead. This is why most physicians have left private practice to join hospital settings or larger groups. Many people don’t know that I have to pay not one but two malpractice payments in the state of Pennsylvania, licensing and board fees, rising medical and office supply fees which total @ 15,000 a month. I have one nurse, a receptionist, myself and one part-time relief doctor who is amazing, having trained at both Duke and Northwestern. I have not taken a paycheck in 8 months.
I continue to do this job because that’s what I was meant to do and I don’t want to give up on my patients. I should not be subject to prejudice for practicing good medicine. I am scared who will take care of these children or my family when those like me are finally forced out completely.
I am not a “healthcare provider”. I am a physician and there is a very big difference. I hope that you will think about this in your fight to fixthe problems in healthcare, because it’s more than just repealing Obamacare. It is putting medicine back into the hands of the patient, consumer, and the physician. Insurance companies are for profit companies, parasitizing my expertise and exploiting your savings. If they are getting paid for my expertise and training, maybe the CEO’s of these insurance companies should try doing the surgeries and treating the patients themselves.
Spending on federal healthcare programs outpaced spending on Social Security for the first time in 2015, according to an expansive report from the congressional budget scorekeeper released Monday.
The government spent $936 billion last year on health programs including Medicare, Medicaid and subsidies related to the Affordable Care Act, a jump of 13 percent from 2014, according to the Congressional Budget Office.
Spending on Social Security, in contrast, totaled $882 billion, the Congressional Budget Office (CBO) reported.
The swelling cost of health programs is likely to ignite an election-year debate on the right over ObamaCare and its impact on the budget.
Democrats will likely argue that the healthcare law is fiscially responsible and needs to be strengthened, in part by toughening regulations on the prescription drug industry.
The CBO report also offers a wider warning about mandatory spending programs and their growing share of the federal budget.
Spending on mandatory programs rose by $200 billion, or 9.5 percent, last year. That’s almost double the average annual rate of increase, 5.4 percent, during the previous decade.
JANUARY 11, 2016, 6:41 PM LAST UPDATED: TUESDAY, JANUARY 12, 2016, 7:11 AM
BY LINDY WASHBURN
STAFF WRITER |
THE RECORD
New recommendations about breast cancer screening — when to start, and how often to do it — were released Monday by a federal task force, but they appear unlikely to have much influence on doctors’ practices in New Jersey.
The guidelines by the U.S. Preventive Services Task Force update their previous recommendations, which led to a public outcry about rationing health care in 2009. That year’s most controversial recommendation — that women in their 40s at average risk of breast cancer should decide for themselves whether to start having screening mammograms every other year — was repeated this time.
Women in their 40s “must weigh a very important but infrequent benefit (a reduction in breast cancer deaths) against a group of meaningful and more common harms,” including callbacks for more imaging studies, biopsies for findings that turn out not to be cancer, and treatment of cancers that would not become life-threatening, the recommendations said.
“The Obama administration said last year that about 85% of enrollees received the subsidy and got an average tax credit of $270 a month.”
The only reason people were willing to buy the overpriced, poor value insurance, was that taxpayers were footing a major portion of the bill. How could our lawmakers have devised such an awful scheme, and then call it “health-care reform?”
A new automated system on the way should alleviate potential problems identified by federal oversight agency
By
STEPHANIE ARMOUR
Jan. 6, 2016 12:00 a.m. ET
The Obama administration wasn’t able to ensure that all tax-credit payments made to insurers under the health law in 2014 were on behalf of consumers who had paid their premiums, according to a federal oversight agency.
However, the agency noted the Obama administration this year is moving to a new automated system that should alleviate potential problems identified in its investigation. The Health and Human Services’ Office of Inspector General is scheduled to release the report Wednesday.
The findings raise questions about the oversight of tax-credit payments that went to insurers on behalf of consumers who qualified for financial assistance.
Tax credits are a major enticement to low- and moderate-income people who buy insurance on exchanges under the Affordable Care Act because they lower monthly premium costs. After consumers sign up for coverage, they can choose to have the federal government distribute the tax-credit payments to insurers to lower their premiums. Nearly $11 billion in tax credits were paid to insurers in fiscal 2014, according to a report by the Treasury Inspector General for Tax Administration.
The Obama administration said last year that about 85% of enrollees received the subsidy and got an average tax credit of $270 a month.
Ridgewood NJ, Rep. Scott Garrett (NJ-05), a senior member of the House Budget Committee, issued the following statement after the House voted for the Restoring Americans’ Healthcare Freedom Reconciliation Act, a budget reconciliation bill which would repeal ObamaCare:
“Many New Jersey families I speak to are suffering from the devastating effects of ObamaCare. People have lost access to their preferred health care and doctors, out-of-pocket costs have increased, premiums have skyrocketed, and some have actually opted to completely forego insurance and instead pay a mandated fine to save money.
“To help these struggling families, today I voted for a budget reconciliation bill that will repeal ObamaCare and relieve our families of the burden placed upon them with this failed health care law. It’s time for President Obama to look at the devastation ObamaCare has caused to hardworking Americans and sign this bill to repeal it.”
The budget reconciliation process eliminates the option of a Senate filibuster and requires the Senate to hold an up or down vote on the bill. Having passed both chambers of Congress, this will be the first time ever that an ObamaCare repeal measure will be presented to the president for his signature or veto.
Click here for a one-page summary of H.R. 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015. For further information on the FY2016 reconciliation process, click here.
Speaker Paul Ryan told colleagues that a major tax package agreed to by leaders in both chambers will postpone the “Cadillac tax” on expensive healthcare plans and place a two-year moratorium on the medical device tax, two critical sources of revenue for ObamaCare.
By Scott Wong,Mike Lillis and Alexander Bolton – 12/15/15 09:55 PM EST
Speaker Paul Ryan (R-Wis.) announced to the House Republican Conference on Tuesday night that leaders have reached a sweeping year-end deal on taxes and funding the government after days of intense negotiations.
The full text of the 2009-page omnibus bill was posted online early Wednesday morning at about 1:30 a.m.
The delayed posting of the omnibus text means that in order to adhere to the so-called “three-day rule,” House GOP leaders will have to wait until Friday to hold a vote on the legislation.
Lawmakers had exited a Tuesday night House GOP conference meeting with the expectation of voting Thursday on the spending package. But Ryan is unlikely to want to waive the self-imposed rule less than two months into his speakership on such a massive bill, meaning the vote will likely slip to Friday.
In the meantime, the House and Senate are expected to easily clear another stopgap measure to keep the government funded through Dec. 22. Current funding expires Wednesday night.
Ryan unveiled the details of the agreement while the political world was fixated on the fifth GOP presidential debate in Las Vegas.
He told colleagues that the spending bill will postpone the “Cadillac tax” on expensive healthcare plans and the tax package will place a two-year moratorium on the medical device tax, two critical sources of revenue for ObamaCare.
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