According to Kaiser, health care spending continues to be lower than it has been in years. The question is why? Maybe it’s because in a tight economy, Americans hold fast to their dollars, including their healthcare dollars. But maybe it is the sense that Americans may be shouldering more of the cost of their own healthcare. And maybe all the discussion around Obamacare has actually led to some awareness and belt tightening before the program even kicks in. That is interesting to me. Maybe there was a lot of waste in the system that is being whittled down in anticipation of lower compensation. Maybe it was time for Americans to take on more responsibility for their health and wellness. Either way, the reformers have to feel buoyed by the knowledge that spending is heading in the right direction. For the moment, that is. Here is a link to a series of articles from the New York Times to Politico.com that offer different thoughts on the subject. http://www.kaiserhealthnews.org/daily-reports/2013/may/07/health-cost-studies.aspx
There is a lot of other information worth noting that may be getting lost in the headlines and general noise around who is to blame. One report I just read says that, according to McKinsey and Company, private employers could dump up to 30% of insured employees as the cost of providing coverage rises. So, the idea that getting a job is the quick fix for getting health insurance benefits is no longer necessarily true.
And what about those State Exchanges? The most closely watched states New Jersey and Florida hemmed and hawed but ultimately, like Missouri, they decided to join the 27 states that think it is best to let the Feds run the show or at least, provide the dollars it will cost to. So much for my hope that states could join together to create bigger purchasing pools that lower costs while providing access. According to Kaiser, “17 Declared State-based Exchange; 7 Planning for PartnershipExchange; 27 Default to Federal Exchange.”
I also think it’s interesting that the employer mandate has been delayed by a year. That eases the pressure for businesses with 50 or more employees who will now have until 2015 to provide coverage or face penalties. The Republicans are saying Obamacare should have been repealed outright and that its delay is an indication of how misguided it was for the Feds to get into the healthcare business. The Democrats are blaming the Republicans and saying that if they had just freed up more money to educate the states on implementation, there wouldn’t be any delays to begin with.
Personally, I’m back to where I began years ago, when I wasn’t reporting or working in politics, which is why couldn’t we just figure out a way to insure the uninsured and leave what was working well enough alone? Consider this article from Sarah Skiff of the Washington Post, who writes, that even with Obamacare, 30 million Americans will be left uninsured.
Welcome to Health Reform Watch, Sarah Kliff’s regular look at how the Affordable Care Act is changing the American health-care system — and being changed by it. You can reach Sarah with questions, comments and suggestions here. Check back every Monday, Wednesday and Friday afternoon for the latest edition, and read previous columns here.
When we talk about the Affordable Care Act, we mostly focus on the millions of Americans who will gain health insurance coverage. We talk less about the millions who will remain uninsured.
And there are a lot of them: 30 million Americans will not have coverage under Obamacare, according to a new analysis in the journal Health Affairs.
“Even if the law were fully implemented, there would have been 26 million uninsured people,” co-author Steffie Woolhandler said in an interview Thursday. “This isn’t just about the Medicaid expansion. This is the system as originally designed.”
Thirty million is a lot smaller than the 48.6 million Americans who lack insurance coverage right now. It’s also, as Woolhandler points out, not exactly breaking news: The Congressional Budget Office estimated over a year ago that between 26 million and 27 million Americans would not have insurance under the expansion.