The Impact of Obamacare, in Four Maps

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Three years into the Affordable Care Act, there remain places where many people still lack health insurance. But their share keeps shrinking.

The share of people without health insurance keeps falling.

Since 2013, when the major provisions of Obamacare went into effect, the uninsured rate has fallen in every state. And some states that you might not expect have led the way.

The news about the Affordable Care Act has been grim lately: The price of health plans in new marketplaces is up, and choice is declining in many places. But amid the difficulties, new data highlight the law’s effectiveness in getting coverage for millions of Americans.

Over all, the gains are substantial: a seven-percentage-point drop in the uninsured rate for adults. But there remain troublesome regional patterns. Many people in the South and the Southwest still don’t have a reliable way to pay for health care, according to the new, detailed numbers from a pair of groups closely tracking enrollment efforts. Those patterns aren’t an accident. As our maps show, many of the places with high uninsured rates had poor coverage before the Affordable Care Act passed. They tend to be states with widespread poverty and limited social safety nets. Look at Mississippi and Texas, for example.

But many of the places that have reduced their uninsured rates the most had similar characteristics in 2013. Look at Kentucky and Arkansas. Over the years, you can see them diverge sharply from their neighbors.

 

Analysis: Time for GOP to prove it has a better plan for healthcare reform

http://www.fiercehealthcare.com/payer/analysis-time-for-gop-to-prove-it-has-a-better-plan-for-healthcare-reform?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTnpkaFpqRm1ZVEZpWkdZMiIsInQiOiJxY1NBT1ZDbGdDQWsxVzRQQ21iOVwvcEVkOFdDVTBIUG9hZWllQ0tiYmFuM2lUVU52Y2JGWkxnNW9BWDJhTWNZSTVTR2QwVmdTYWdIQkFPWGdxZ3FRWlwvRXVuSFFvZ2pKa3NaTUlwU0M1YmVJPSJ9

With Donald Trump headed to the White House and his party firmly in control of Congress, Republicans will finally have a chance to prove what they’ve been saying all along: that they can produce a better version of healthcare reform than the Affordable Care Act.

It’s clear that the ACA is as imperiled as it has ever been. Trump has fervently vowed to repeal it–and with Republican control of both chambers of Congress, he may well get his wish. After all, the law’s most visible component, the exchanges, are on shaky ground as it is, with premiums rising and some health insurers retreating from the marketplaces.

Plus, President Barack Obama’s last attempt at convincing Republicans to work on fixing the ACA–not repealing it–fell on deaf ears even before the party’s resounding victory Tuesday.

What gets lost in all the talk about the ACA’s uncertain future, though, is the fact that while some insurers have struggled to make a profit in the individual marketplaces, there are other aspects of the law to which they have become quite attached.

Take Medicaid expansion, an idea championed by Democrats (and even once embraced by Vice President-Elect Mike Pence) that has been a boon to insurance companies in the form of lucrative managed care contracts. Some companies that specialize in slimmed-down Medicaid plans have also thrived on the exchanges where others have floundered.

Then there’s the ACA’s provisions that encourage the transition to value-based payments, which insurers have embraced and largely retooled their business models to reflect. Accountable care organizations, for example, have sprung up like wildfire, producing promising results for some companies.

A wholesale repeal of the ACA would also erase the law’s historic gains in reducing the uninsured rate. Though many of the newly insured have turned out to be costlier to cover than expected, such a move would still rob insurers of millions of new customers.

The question, then, becomes what will replace the law–and that’s where it gets interesting.

Trump has a plan, but it is short on details. Perhaps most visibly, he has advocated for selling insurance across state lines–a timeworn GOP talking point that many experts agree is not feasible. He would also repeal Medicaid expansion and convert Medicaid federal matching funds into a block grant, the latter of which would drastically cut Medicaid funding and coverage.

One analysis from The Commonwealth Fund says that his plan could add nearly 20 million peopleto the ranks of the uninsured, and even more if his Medicaid proposals come to fruition.

California Faces Major Reversal If Trump, Congress Scrap Health Law

California Faces Major Reversal If Trump, Congress Scrap Health Law

Attendees speak with heath care volunteers during the WeConnect Health Enrollment Information & Wellness Event in Oakland, California, U.S., on Saturday, Sept. 21, 2013. The battle over Obamacare is taking on political importance as Democrats hope a successful roll-out among Hispanics will further bind those voters to the Democratic Party and undermine Republican efforts to build more support before the 2016 presidential election. Photographer: David Paul Morris/Bloomberg via Getty Images

California has a lot to lose if President-elect Donald Trump and the Republican-led Congress fulfill their campaign pledge to repeal Obamacare.

The Golden State fully embraced the Affordable Care Act by expanding Medicaid coverage for the poor and creating its own health insurance exchange for about 1.4 million enrollees. Supporters held California up as proof the health law could work as intended.

But now President Barack Obama’s signature law is in serious jeopardy and California officials are left wondering what Republicans in Washington may put in its place.

“There is no doubt that Obamacare is dead,” said Robert Laszewski, a health care consultant and expert on the California insurance market. “The only question is just exactly how Republicans will get rid of it.”

Health policy experts don’t expect Republicans to immediately kick millions of people off their insurance policies. Instead, they predict lawmakers may repeal parts of the law and allow for some transition period for consumers while a replacement plan is put together.

Still, the personal and financial impact for the state could be jarring. The number of uninsured Californians would more than double to 7.5 million people if the Affordable Care Act was repealed, according to a recent study by the Urban Institute.

Researchers also said California stands to lose an estimated $15 billion annually in federal funding for Medicaid expansion and insurance subsidies — more than any other state. That loss of federal money would make it difficult for California to pursue health reform on its own.

Hillary Clinton’s healthcare proposals a mixed bag for nonprofits, Trump plan lacks detail, Fitch says

http://www.healthcarefinancenews.com/news/hillary-clintons-healthcare-proposals-mixed-bag-nonprofits-trump-plan-lacks-detail-fitch-says

Clinton’s plan to expand Medicaid in the 19 states that declined to do so would benefit nonprofit hospitals in those states, Fitch says.

Paul Ryan Makes Huge (Yet Really Obvious) Admission About Obamacare

http://www.huffingtonpost.com/entry/paul-ryan-huge-admission-obamacare_us_5820b47ee4b0d9ce6fbd8499?hgh2kk4wa02j4i

House Speaker Paul Ryan (R-Wis.) hasn’t lost his grip on reality, he revealed Monday during an interview with conservative radio host Jay Weber.

Ryan admitted that a victory by Democratic presidential nominee Hillary Clintonwould mark the end of his quixotic quest to repeal the Affordable Care Act. That may seem like an obvious conclusion, but it qualifies as a noteworthy statement because it’s coming from the man who oversaw dozens of hopeless votes to overturn the 6-year-old health care law.

During the discussion on WISN, Weber laid out a series of “hard truths” with respect to the stakes in the presidential and congressional elections if Republicans fail to win the White House and lose the Senate, including Democrats being able to confirm Clinton’s Supreme Court nominees.

Here’s Weber and Ryan discussing the Affordable Care Act:

http://www.healthcaredive.com/news/ryan-accepts-aca-here-to-stay-if-clinton-wins/429898/

 

Uninsured In Coal Country: Desperate Americans Still Turn To Volunteer Clinics

http://khn.org/news/uninsured-in-coal-country-desperate-americans-still-turn-to-volunteer-clinics/

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Six years after the passage of the Affordable Care Act, and despite 20 million more Americans gaining health insurance, considerable gaps in health care remain.

The decision by states like Virginia not to expand Medicaid and the lack of dental and vision coverage even for those with insurance have meant that the demand for RAM’s free mobile clinics has stayed strong.

An ACA primer: Much more than insurance

http://www.healthcaredive.com/news/an-aca-primer-much-more-than-insurance/429497/

Remember the Affordable Care Act? Enacted in 2010, it expanded healthcare insurance to millions of uninsured Americans and increased access to care. But the ACA is much more than expanded coverage; it set in motion a variety of reforms in the healthcare delivery systems aimed at lowering costs and improving quality of care.

That fact was lost on presidential candidate Donald Trump, who told Fox News recently, “I don’t use much Obamacare, I must be honest with you, because it is so bad for the people and they can’t afford it.” Trump’s comments imply Obamacare is an insurance plan people can buy, which is not the case. As we wrap up year six since the ACA was enacted, here‘s what the law is really about and how it impacts providers.

Vermont’s all-payer ACO will begin in January

http://www.modernhealthcare.com/article/20161026/NEWS/161029930/vermonts-all-payer-aco-will-begin-in-january

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In January, Vermont will become the first state in the nation to move to a voluntary all-payer accountable care organization model, the CMS announced Wednesday.

The Vermont program is modeled after a similar one from Maryland, but the Maryland program covers only hospitals. The Vermont ACO will cover Medicare, Medicaid and commercial payers, requiring those who participate to pay similar rates for all services.

The CMS is giving Vermont $9.5 million in start-up funding to support the transition. The demonstration, funded through a 1115 waiver, will last five years.

“This model is historic in terms of its scope, aiming to include almost all providers and people throughout the state in an all-payer ACO model to drive improved quality, better care coordination, healthier people, and smarter spending,” the CMS’ Chief Medical Officer Patrick Conway said in a statement.

“We will become the first state in America to fundamentally transform our entire health care system so it is geared towards keeping people healthy, not making money,” said Vermont Gov. Peter Shumlin, who earlier this year traveled to Washington to negotiate a deal with HHS Secretary Sylvia Mathews Burwell.

The state aims to have 70% of its insured residents covered by an ACO by 2022. The model will be considered an advanced alternative payment model under the new Medicare reimbursement program, making participants eligible for a performance bonus.

Vermont all-payer ACO model approved, will count for MACRA

http://www.healthcarefinancenews.com/news/vermont-all-payer-aco-model-approved-will-count-macra

Under model, rates paid to a given provider are set so that all third parties pay the same price for services to particular provider.

Clinton vs. Trump: 5 critical election issues

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/hillary-vs-trump-5-critical-election-issues?cfcache=true&ampGUID=A13E56ED-9529-4BD1-98E9-318F5373C18F&rememberme=1&ts=25102016

While Hillary Clinton vows to forge ahead with Obamacare if she is elected president, Donald Trump would scrap it altogether. The end results would be two very different forms of healthcare, and industry leaders have much to consider.

Brill“Many different factors are weighing on managed care executives such as the costs of pharmaceuticals, diagnostics and devices; the impact of consolidation amongst hospitals, physicians, health plans; and the losses in the exchange marketplace,” says Managed Healthcare Executive editorial advisor Joel V. Brill, MD, chief medical officer, Predictive Health, LLC, which partners with stakeholders to improve coverage of value-driven care. “With each of these factors, plans can, at least at a high level, make some educated guesses about the relative risk of each factor and impact to the bottom line.”

The election results, however, are much less certain, which from a risk perspective, weighs heavily on the minds of healthcare executives, Brill says. “How can you plan for business knowing that whatever you are doing currently could be upended in the beginning of November?”

To help provide some clarity, Managed Healthcare Executive identified five of the top industry issues, reviewed the candidates’ platforms for each, and asked industry experts to weigh in.