Author Topic: Because you voted for it - ObamaCare to hike premiums by up to 200% -  (Read 6553 times)

OzmO

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Mine didn't go up or down.  However, i have friends in the medical industry and they are starting to hear of rumors of downsizing as a result of Obamacare.

So until there are actual reports with actual numbers........  ::)

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Mine didn't go up or down.  However, i have friends in the medical industry and they are starting to hear of rumors of downsizing as a result of Obamacare.

So until there are actual reports with actual numbers........  ::)


More Docs Plan to Retire Early

Six in 10 physicians said it is likely many of their colleagues will retire earlier than planned in the next 1 to 3 years.




By David Pittman, Washington Correspondent, MedPage Today




WASHINGTON — THURSDAY, March 21, 2013 (MedPage Today) — Most physicians have a pessimistic outlook on the future of medicine, citing eroding autonomy and falling income, a survey of more than 600 doctors found.

Six in 10 physicians (62 percent) said it is likely many of their colleagues will retire earlier than planned in the next 1 to 3 years, a survey from Deloitte Center for Health Solutions found. That perception is uniform across age, gender, and specialty, it said.

Another 55 percent of surveyed doctors believe others will scale back hours because of the way medicine is changing, but the survey didn't elaborate greatly on how it was changing. Three-quarters think the best and brightest may not consider a career in medicine, although that is an increase from the 2011 survey result of 69 percent.

"Physicians recognize 'the new normal' will necessitate major changes in the profession that require them to practice in different settings as part of a larger organization that uses technologies and team-based models for consumer (patient) care," the survey's findings stated.

About two-thirds of the survey responders said they believe physicians and hospitals will become more integrated in coming years. In the last 2 years, 31 percent moved into a larger practice, results found. Nearly eight in 10 believe midlevel providers will play a larger role in directing primary care.

Four in 10 doctors reported their take-home pay decreased from 2011 to 2012, and more than half said the pay cut was 10 percent or less, according to Deloitte. Among physicians reporting a pay cut, four in 10 blame the Affordable Care Act (ACA), and 48 percent of all doctors believed their income would drop again in 2012 as a result of the health reform law.

Other findings:
26 percent believe Medicare's sustainable growth rate formula will be repealed in the next 1 to 3 years
One in 10 believe medical liability reform will pass Congress in the next 1 to 3 years
A quarter of physicians would place new or additional limits on accepting Medicare patients if there were payment changes
55 percent of physicians believe the hospital-doctor relationship will suffer as admitting privileges are put at risk to comply with hospital standards of meaningful use
31 percent gave the U.S. healthcare system a favorable grade of "A or B" compared with 35 percent in 2011

Despite those pessimistic views, seven of 10 said they were satisfied about practicing medicine, although that number was lower for primary care providers and higher for younger age groups, the survey found. Dissatisfaction was attributed toward less time with patients, long hours, and dealing with Medicare, Medicaid, and government regulations.

Speaking of the ACA, fewer physicians (38 percent in 2012) believe the ACA is a step in the wrong direction compared with 44 percent in 2011. The number who think the law is a good place to start remained the same.

Two-thirds of physicians in the Deloitte survey say they use an electronic health record (EHR) that meets meaningful use stage 1 requirements, but that number has been lower in other surveys. Three in 5 respondents were satisfied with their EHR.

Deloitte mailed the survey to more than 20,000 physicians selected from the American Medical Association's master file. Just 613 returned completed surveys, giving a margin of error of 3.9 percent at the 0.95 confidence level.

Source: Survey: More Docs Plan to Retire Early

http://www.everydayhealth.com/senior-health/more-docs-plan-to-retire-early.aspx


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U.S. NEWSUpdated March 22, 2013, 8:04 a.m. ET.Health Insurers Warn on Premiums .


By ANNA WILDE MATHEWS and LOUISE RADNOFSKY


 
Health insurers are privately warning brokers that premiums for many individuals and small businesses could increase sharply next year because of the health-care overhaul law, with the nation's biggest firm projecting that rates could more than double for some consumers buying their own plans.

The projections, made in sessions with brokers and agents, provide some of the most concrete evidence yet of how much insurance companies might increase prices when major provisions of the law kick in next year—a subject of rigorous debate.

 
Health insurers are privately warning brokers that premiums for many individuals and small businesses could increase sharply next year because of the health-care overhaul law. Photo: Getty Images.


 
The role that pharmacies play in the health-care system is expanding. But that doesn't necessarily mean that consumers are better off. MarketWatch's Christopher Noble reports. (Photo: Getty Images)
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The projected increases are at odds with what the Obama Administration says consumers should be expecting overall in terms of cost. The Department of Health and Human Services says that the law will "make health-care coverage more affordable and accessible," pointing to a 2009 analysis by the Congressional Budget Office that says average individual premiums, on an apples-to-apples basis, would be lower.

The gulf between the pricing talk from some insurers and the government projections suggests how complicated the law's effects will be. Carriers will be filing proposed prices with regulators over the next few months.

Part of the murkiness stems from the role of government subsidies. Federal subsidies under the health law will help lower-income consumers defray costs, but they are generally not included in insurers' premium projections. Many consumers will be getting more generous plans because of new requirements in the law. The effects of the law will vary widely, and insurers and other analysts agree that some consumers and small businesses will likely see premiums go down.

Starting next year, the law will block insurers from refusing to sell coverage or setting premiums based on people's health histories, and will reduce their ability to set rates based on age. That can raise coverage prices for younger, healthier consumers, while reining them in for older, sicker ones. The rules can also affect small businesses, which sometimes pay premiums tied to employees' health status and claims history.

 
Associated Press
 
UnitedHealth Group, the nation's largest carrier, and other health insurers said premiums for some individuals and small businesses could rise.
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The law's 2014 effect on larger companies is likely to be more limited. Many of the big changes coming next year won't touch them as directly as individual consumers and small businesses, though some will have to grapple with the cost of covering more workers or paying a penalty.

The possibility of higher premiums has become the latest focal point of the political tussle over the health law, which marks its third anniversary Saturday. Republican lawmakers have held hearings on the issue, and six GOP members of the House Energy and Commerce committee wrote last week to more than a dozen insurers asking them to turn over internal analyses on the law's impact on premiums and costs.

The insurance industry has also been talking publicly about big potential premium increases in lobbying for tweaks to the law.

The individual market includes about 15 million people, and around 18% of the roughly 149 million with employer coverage were at small companies, according to 2011 figures from the Kaiser Family Foundation. The individual market is expected to grow to around 35 million people by 2016 as a result of the law.

In a private presentation to brokers late last month, UnitedHealth Group Inc., UNH -1.13%the nation's largest carrier, said premiums for some consumers buying their own plans could go up as much as 116%, and small-business rates as much as 25% to 50%. The company said the estimates were driven in part by growing medical costs not directly tied to the law. It also cited the law's requirements that health status not affect rates and that plans include certain minimum benefits and limits to out-of-pocket charges, among other things.

Jeff Alter, who leads UnitedHealth's employer and individual insurance business, said the numbers represented a "high-end scenario," not an average. "There are some scenarios in which a member could see as much as a 116% increase or over," he said, though others, such as some older consumers, could see decreases. He said the company dwelled on the possible increases because it was trying to prepare brokers to speak with clients facing big jumps.

Other carriers have also projected steep rate increases during private meetings and conversations with brokers. Brokers say they are being told to prepare the marketplace for small-business and individual rate increases as carriers get ready to file specific rate proposals and plan designs with regulators.

Insurers are "not being shy that premiums are going to increase in 2014," and are urging brokers to "brace our clients," said John Lacy, vice president of group benefits at Bouchard Insurance, a brokerage in Clearwater, Fla. His firm has been hearing from carrier representatives that individual premiums in Florida could go up 35% to 50%, on average, and small-business rates around 30%, though it hopes to find strategies to blunt the impact.

Aetna Inc., AET -0.60%in a presentation last fall to its national broker advisory council, suggested rates on individual plans not being grandfathered under the law could go up 55%, on average, and gave a figure of 29% for small business rates. Both numbers included 10 percentage points tied to medical-cost inflation, not the law. An Aetna spokesman said the numbers are "still generally in line with what we've been estimating," and represented the average impact in a typical state.

An official with Blue Cross & Blue Shield of North Carolina told a gathering of brokers last week that individual premiums could go up by as much as 40% to 50%, according to brokers who were present. A spokeswoman for the insurer said "we don't have final numbers" yet on premiums.

There has long been debate, even among insurance experts, over how the law will affect premiums. Because the effect is likely to vary, different measurements can arrive at different conclusions. The CBO analysis cited by the administration determined that average premiums for consumers who buy their own coverage would be 14% to 20% lower because of the law—if the law didn't change the types of plans they purchased.

But the CBO also suggested the law would lead to consumers buying more expensive plans, largely because it requires coverage to include certain benefits and limit charges such as deductibles. When this effect was taken into account, the average premiums would go up 10% to 13%, the agency said, though subsidies would ease the bite for most people. The agency also said small-business policies were likely to cost within a few percentage points of the amount they would have without the law.

Health and Human Services officials say competition among insurers, as well as provisions to limit their financial risk from attracting high-cost consumers, will exert downward pressure on premiums, and point to the tax subsidies that will limit many consumers' costs.

Subsidies will be available on a sliding scale for people with incomes of up to four times the federal poverty level—currently $45,960 for a single person and $94,200 a year for a family of four. More than half of the 35 million people expected to be in the individual market by 2016 are likely to qualify for credits. People whose incomes are around the poverty level could see almost all of the cost of their insurance subsidized, while people at the upper end will get only a small discount toward their premiums.

Write to Anna Wilde Mathews at anna.mathews@wsj.com and Louise Radnofsky at louise.radnofsky@wsj.com

A version of this article appeared March 22, 2013, on page A1 in the U.S. edition of The Wall Street Journal, with the headline: Health Insurers Warn on Premiums.


http://online.wsj.com/article/SB10001424127887324557804578374761054496682.html


OzmO

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More Docs Plan to Retire Early

Six in 10 physicians said it is likely many of their colleagues will retire earlier than planned in the next 1 to 3 years.




By David Pittman, Washington Correspondent, MedPage Today




WASHINGTON — THURSDAY, March 21, 2013 (MedPage Today) — Most physicians have a pessimistic outlook on the future of medicine, citing eroding autonomy and falling income, a survey of more than 600 doctors found.

Six in 10 physicians (62 percent) said it is likely many of their colleagues will retire earlier than planned in the next 1 to 3 years, a survey from Deloitte Center for Health Solutions found. That perception is uniform across age, gender, and specialty, it said.

Another 55 percent of surveyed doctors believe others will scale back hours because of the way medicine is changing, but the survey didn't elaborate greatly on how it was changing. Three-quarters think the best and brightest may not consider a career in medicine, although that is an increase from the 2011 survey result of 69 percent.

"Physicians recognize 'the new normal' will necessitate major changes in the profession that require them to practice in different settings as part of a larger organization that uses technologies and team-based models for consumer (patient) care," the survey's findings stated.

About two-thirds of the survey responders said they believe physicians and hospitals will become more integrated in coming years. In the last 2 years, 31 percent moved into a larger practice, results found. Nearly eight in 10 believe midlevel providers will play a larger role in directing primary care.

Four in 10 doctors reported their take-home pay decreased from 2011 to 2012, and more than half said the pay cut was 10 percent or less, according to Deloitte. Among physicians reporting a pay cut, four in 10 blame the Affordable Care Act (ACA), and 48 percent of all doctors believed their income would drop again in 2012 as a result of the health reform law.

Other findings:
26 percent believe Medicare's sustainable growth rate formula will be repealed in the next 1 to 3 years
One in 10 believe medical liability reform will pass Congress in the next 1 to 3 years
A quarter of physicians would place new or additional limits on accepting Medicare patients if there were payment changes
55 percent of physicians believe the hospital-doctor relationship will suffer as admitting privileges are put at risk to comply with hospital standards of meaningful use
31 percent gave the U.S. healthcare system a favorable grade of "A or B" compared with 35 percent in 2011

Despite those pessimistic views, seven of 10 said they were satisfied about practicing medicine, although that number was lower for primary care providers and higher for younger age groups, the survey found. Dissatisfaction was attributed toward less time with patients, long hours, and dealing with Medicare, Medicaid, and government regulations.

Speaking of the ACA, fewer physicians (38 percent in 2012) believe the ACA is a step in the wrong direction compared with 44 percent in 2011. The number who think the law is a good place to start remained the same.

Two-thirds of physicians in the Deloitte survey say they use an electronic health record (EHR) that meets meaningful use stage 1 requirements, but that number has been lower in other surveys. Three in 5 respondents were satisfied with their EHR.

Deloitte mailed the survey to more than 20,000 physicians selected from the American Medical Association's master file. Just 613 returned completed surveys, giving a margin of error of 3.9 percent at the 0.95 confidence level.

Source: Survey: More Docs Plan to Retire Early

http://www.everydayhealth.com/senior-health/more-docs-plan-to-retire-early.aspx



 ::)  bull shit

Six in 10 physicians said it is likely many of their colleagues will retire earlier than planned in the next 1 to 3 years?   that's such stupid spun sentence 

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Over 30 Senate Democrats vote to repeal the medical device tax
 Hotair ^ | 03/22/2013 | Erika Johnsen


Posted on Friday, March 22, 2013 2:58:17

As I mentioned yesterday, the medical device tax that went into effect last January is just one of the many insidious job-killing measures contained within ObamaCare, but it is an especially terrible one. The 2.3 percent excise tax is meant to raise a handsome $30 billion to pay for ObamaCare over the next decade, except that, added bonus: It’s going to stifle innovation and competition in an industry that provides all manner of life-saving medical devices, from MRIs to pacemakers to blood tubes.

And this hasn’t just been a Republican refrain, by the way. Thursday night, the Senate voted overwhelmingly to repeal the medical device tax, with more than 30 Democrats joining in:


The vote was largely symbolic, but the 79-20 tally signals strong opposition to the 2.3% tax on device sales that went into effect Jan. 1. Even though the levy is meant to help foot the bill for the signature legislative achievement of President Barack Obama‘s first term, 33 Democrats as well as independent Sen. Angus King of Maine joined Republican senators in voting to repeal the tax.

The vote came as an amendment to the Senate Democrats’ fiscal year 2014 budget, a partisan tax-and-spending blueprint that stands no chance of passing the GOP-controlled House. Still, the solid bipartisan support shows growing momentum for repealing the tax, which lawmakers have argued hurts U.S. competitiveness and costs highly paid jobs.

Sen. Orrin Hatch (R., Utah) introduced the measure earlier Thursday with the support of nine Democrats, including Sen. Elizabeth Warren of Massachusetts and Sen. Sheldon Whitehouse of Rhode Island.

I do wonder that some of these Democrats couldn’t summon these same scruples with the health care overhaul when they were falling over themselves to pass the dang thing in 2010, though. Such a shame.

The vote may have been a symbolic one, but nevertheless, this has got to be kind of uncomfortable for the White House: Congress finally managed to find some bipartisan agreement on something, and it’s over just how stupid of a funding-mechanism idea this medical device tax was to begin with.

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ObamaCare at Three: Headed Toward Failure?
 


By Ben Domenech - March 22, 2013
 













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Today’s the three year anniversary of the final House vote on Obamacare. It is one ugly toddler, and its first steps are turning out to be disastrous. But is it here to stay?
 
From the beginning, there were three ways to replace Obama’s signature domestic policy achievement. The first and best option was that you could replace it by winning an election – and it would have to be a definitive win, not just the White House but the Senate, too. Republicans utterly failed to do this. Second, you could count on the Supreme Court to gut its central support mechanism, the individual mandate. Thanks to John Roberts, this also failed, but not utterly, since the surprise 7-2 decision allowed states the freedom to block the Medicaid expansion, a massive entitlement increase which made up the bulk of the coverage increase under the program. But after both of these failures, the general chorus in the media is that the right has to give up on repealing Obamacare altogether – that it should accept it and work to implement it. See the recent complaints from Nita Lowey and others about the lack of funding for implementation, who will certainly cite this as the reason for a clumsy launch of the online systems this fall.
 




They seem to have forgotten about the third path: the right can replace Obamacare if it fails. And thus far, it gives every indication of failing. It has contributed to growing premium costs. Its budget impacts have been revised only in a negative direction (indeed, the only positives have been from fewer states implementing the Medicaid expansion). It has already been stripped of one mathematically and actuarially unsound entitlement. Most Republican governors have no interest in helping implement a program they believe to be ill-thought from its inception, and even Democrats don’t want their fingerprints at the state level on exchanges and Medicaid expansions their systems can’t handle.
 
The tea leaves from the implementers are not optimistic at all. Consider the latest lines from Henry Chao at CMS: “Chao was frank about the stress and tension of the compressed time frame involved in setting up the exchanges. “We are under 200 days from open enrollment, and I’m pretty nervous,’’ he said. “I don’t know about you,” he added, to murmurs from the insurance industry audience. Members peppered Chao and Cohen with many questions about the format for the health care policies they will submit to HHS for approval so the plans can be marketed in the exchanges. Chao said the main objective is to get the exchanges up and running and signing up the uninsured. “The time for debating about the size of text on the screen or the color or is it a world-class user experience, that’s what we used to talk about two years ago,” he said. “Let’s just make sure it’s not a third-world experience.” You’ve had three years and billions of dollars to work with, and you’re talking about being fearful of a “third-world experience” in the exchanges?
 
Part of the problem is how much the Obama administration counted on the states to do the implementation job. Instead, you have 33 states where the administration must run the insurance exchanges in whole or in part. And this extends to Medicaid expansion as well: the primary motivation for the Arkansas compromise endorsed by HHS, for instance, was not just the coverage expansion – it was that Arkansas’ own health department staff, in a Democratic administration, said that they couldn’t handle the sheer bureaucratic lift of adding a quarter of a million people to a program already rife with problems. Laughably, today Bloomberg’s editors came out today against the Arkansas approach to Medicaid reform – because they apparently believe: “Medicaid is efficient, delivering a high standard of care at rock-bottom cost." The divide between the national conversation and those at the state level is absurd on this score, and it’s one reason why the amount of balking at “free money” surprised so many people who don’t spend much time working with legislators.
 
So implementation is going to get messy, and in ways that will impact people’s lives far more directly than the instability of the early days of Medicare Part D. We’re not just talking about getting you a drug, keep in mind – we’re talking about births, limbs, surgery, transplants, life and death. That’s one reason Democrats have already shown themselves willing to be far more critical post-2012. They think this is fine because the law appears secure. But it’s also still very unpopular, with Democratic support dropping substantially since the election. Removed from the conflict of electoral politics, Obamacare requires less ideological fealty, and pointing out its flaws becomes less an act of betrayal than an admission of the obvious.
 
The central problem here is that Obama promised too much, and Obamacare will deliver too little. The Repeal Coalition will continue to work to undermine it at every opportunity, and the nature of its passage means that there is no foreseeable avenue for the normal bipartisan fixes and tweaks to make a sweeping law work better. Instead, Republicans are likely to seize on every sad story as justification for dramatic changes – and in 2016, mount campaigns designed to replace the system in whole or in part with plenty of material to use in their cause. It’s very possible, perhaps even likely, that moderate Democrats will run in 2014 promising to “fix Obamacare” in one sense or another.
 
Democrats privately admit they’re worried about implementation, but they are counting on government largesse to insulate them. They figure once the funding for Medicaid expansion and exchange subsidies goes out the door in 2014, they’ll be just fine. Perhaps. But Americans dislike dramatic shifts in experience and disruption – one reason Obama promised, ridiculously, that if you like your plan and doctor you can keep them – and Obamacare is nothing if not disruptive. Confidence that it will endure beyond 2016 in its current form requires believing that it will work, that it will become more popular, and that premium costs will not continue to rise. If that happens, it will endure. If not, within a few years, it will be reformed in part or replaced entirely.
 

Benjamin Domenech is editor of The Transom. Click here to subscribe.


Read more: http://www.realclearpolitics.com/articles/2013/03/22/obamacare_at_three_headed_toward_failure.html#ixzz2OIqKqqdD
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Op-ed: A year later, we’re worse off with the Affordable Care Act
NBC ^ | 3/23/2013 | Jennifer Korn, Hispanic Leadership Network
Posted on March 23, 2013 12:17:27 PM EDT by tobyhill

An anniversary is often a joyous occasion, a time to commemorate and celebrate an important milestone. For America’s families, businesses, employees, and consumers, however, March 23rd, the third anniversary of the Affordable Care Act (ACA), might not fit into the same category of bliss.

The vast majority of people in America believe that our health care system needs improvement, especially when it comes to access and affordability of care. Yet, while the 2010 health care law began with good intentions, it quickly ventured off into negative territory.

In a difficult economy, and an otherwise uncertain spending and regulatory environment, ACA leaves small employers with a large paperwork burden, higher costs, and an even greater degree of uncertainty.

The news for these businesses is not good. Many employers have seen their premiums increase or plans disappear entirely. The National Federation of Independent Business (NFIB) has said that, in a recent study, one in eight employers reported that their health insurance providers had notified them that their plans would be terminated. Another recent study by human resources consulting firm Adecco reveals that nearly a third of employers said they stopped hiring or cut their workforce because of the law.

(Excerpt) Read more at nbclatino.com ...

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I live in Tax-You-Up-The-Assachusetts where Twit Romney enacted Obomneycare and I might have to pay a penalty for not having health care, because I've been on a temp-to-hire job where they don't give benefits until you're signed on full-time. Good thing I made a ton of money selling my Netflix stock.

It's not the same. People keep comparing Romneycare to Obamacare.

http://www.sfgate.com/opinion/saunders/article/Obamacare-is-not-the-same-as-Romneycare-3917862.php

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Obamacare Costs Spark Voter Cynicism
 National Review ^ | 03/25/2013 | Michael G. Franc

Posted on Monday, March 25, 2013 9:59:40 AM by SeekAndFind

Ask any pollster. Distrust of the government in Washington stands at unprecedentedly high levels. Between three-quarters (Pew) and four-fifths (Gallup) of Americans now instinctively question the veracity of promises from politicians and government agencies. Their frustration with all things governmental, in fact, has reached the boiling point. According to one recent poll by the Pew Research Center, “For the first time, a majority of the public [53 percent] says that the federal government threatens their personal rights and freedoms.”

Nowhere is this frustration and distrust more apparent than in the realm of health policy. Three years after the enactment of Obamacare, the level of skepticism about it remains high. Pollster Scott Rasmussen has found that, despite repeated assurances from the president and other Democrats, Americans remain convinced that Obamacare will make things worse. Voters believe the quality of their health care will deteriorate even as their costs continue to skyrocket. Federal budget deficits, moreover, will worsen. Revealingly, the level of their cynicism goes hand in hand with how much experience they have had with government promises — i.e., older voters are by far the most cynical.

The voters’ cynicism, however, is most rampant in their overwhelming sense that “the health care reform law will cost more than the official estimates.” Fully 73 percent of respondents overall, Rasmussen found, trust their own instincts over the official projections of government bean-counters, with three-quarters or more of men, seniors, whites, independents, and voters with annual incomes over $20,000 doubting the government. Even 58 percent of Democrats and 59 percent of liberals concur. The caucus of true believers in government is a small one.

The voters’ distrust is well founded. Nearly half a century ago, Congress established the two programs that lie at the heart of today’s fiscal crunch: Medicare and Medicaid. The bean-counters assured lawmakers that these brand new entitlements were affordable. By 1990, they predicted, Medicare’s hospital benefits would cost taxpayers “only” $9 billion. The actual cost was a cool $67 billion.

The most egregiously wrong prediction came two decades after the programs were launched. It had to do with the portion of the Medicaid program that sends cash to hospitals that treat large numbers of low-income and uninsured patients. In 1987, congressional budget experts assured lawmakers that the cost of this health-care entitlement five years hence would be less than $1 billion. The actual cost, thanks to accounting shenanigans by hospitals and complicit state governments, was an astounding $17 billion.

Sadly, underestimating the real costs of government-run health-care programs is the norm. This has been true for Medicare costs relating to kidney dialysis, coverage for catastrophic illness, home health care, the State Children’s Health Insurance Program, and, more recently, the subsidy for nursing-home costs included in Obamacare (known as the CLASS Act). Obama administration officials quickly shelved this latest entitlement upon learning that costs would so exceed projections as to be unsustainable, and it was recently repealed. The exceptions to the rule that costs of government-run health care will always outrun predictions are programs where the patients control the dollars spent on their care, such as the federal-employee health-insurance system, Medicare Part D (prescription-drug coverage), and consumer-directed and flexible spending accounts.

Where will the next huge cost overruns arise? From Obamacare’s expansion of Medicaid, which is scheduled to add 17 million Americans to the 70 million currently enrolled in this beleaguered program. Governors and state lawmakers are now assessing whether they should succumb to the siren song of federal subsidies.

But this would be a foolish decision. Today’s Medicaid patient already encounters enormous obstacles just getting in to see a physician, with worse health outcomes as a result. One 2009 survey of more than 1,100 physician practice groups nationwide found that over two-thirds of Medicaid patients seeking physical exams or in need of routine cardiology or gynecological care were turned away in cities such as Philadelphia, San Diego, Miami, New York, and Dallas. Fewer than one in ten of the physician practices surveyed in Philadelphia and Dallas, for example, would accept Medicaid patients looking for a heart checkup.

These findings are nothing new. As far back as 1993, peer-reviewed studies documented that Medicaid patients incurred worse health outcomes in areas as diverse as childhood asthma; breast, cervix, colon, and lung cancers; myocardial infarctions; strokes; and pneumonia than do comparable patients with private insurance. Asked to explain why they refuse to see Medicaid patients, physicians pointed to the impenetrable government paperwork and bureaucratic obstacles they encounter as well as to Medicaid’s notoriously low reimbursement rates.

Medicaid’s crisis, moreover, has spread to the entire health sector. A 2012 national survey of nearly 14,000 physicians identified a “silent exodus of physicians from the workforce” driven by “significant changes to the medical practice environment,” including physicians’ frustration with the recent round of health reforms. “Physicians,” the researchers found, “are working fewer hours, seeing fewer patients and limiting access to their practices.” Within four years, the equivalent of over 44,000 physicians will leave the workforce, and more than half will “cut back on patients seen, work part-time, switch to concierge medicine, retire, or take other steps likely to reduce patient access.”

Governors and state lawmakers beware: This “silent exodus” of physicians comes at precisely the time when Obamacare will be asking states to add fuel to Medicaid’s raging fire. And the temptation to embark on this fiscally foolhardy path will be great. Obamacare’s architects are offering a generous — but temporary — 100 percent federal payment to cover the cost of the expansion, as well as federal coverage of a temporary increase in the fees primary-care doctors receive for seeing Medicaid patients. But, like the cherry blossoms that ring the Tidal Basin, these payments will quickly wither away, leaving it to the states — suffering from the fiscal straitjacket Medicaid already puts on their budgets — to assume the burgeoning costs of Obamacare’s Medicaid expansion.

Far better to embrace Medicaid reforms that put patients first.

— Michael G. Franc is vice president of government studies for the Heritage Foundation.

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Mar 26, 2:03 PM EDT

 
Study: Health overhaul to raise claims cost 32 pct

By RICARDO ALONSO-ZALDIVAR
Associated Press
 










AP Photo/J. Scott Applewhite

 






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WASHINGTON (AP) -- Medical claims costs - the biggest driver of health insurance premiums - will jump an average 32 percent for Americans' individual policies under President Barack Obama's overhaul, according to a study by the nation's leading group of financial risk analysts.
 
The report could turn into a big headache for the Obama administration at a time when many parts of the country remain skeptical about the Affordable Care Act. The estimates were recently released by the Society of Actuaries to its members.
 
While some states will see medical claims costs per person decline, the report concluded the overwhelming majority will see double-digit increases in their individual health insurance markets, where people purchase coverage directly from insurers.
 
The disparities are striking. By 2017, the estimated increase would be 62 percent for California, about 80 percent for Ohio, more than 20 percent for Florida and 67 percent for Maryland. Much of the reason for the higher claims costs is that sicker people are expected to join the pool, the report said.
 
The report did not make similar estimates for employer plans, the mainstay for workers and their families. That's because the primary impact of Obama's law is on people who don't have coverage through their jobs.
 
The administration questions the design of the study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick. The study also doesn't take into account the potential price-cutting effect of competition in new state insurance markets that will go live on Oct. 1, administration officials said.
 
"It's misleading to look at only some of the provisions of the law because, taken together, the law will reduce costs," said Health and Human Services spokeswoman Erin Shields Britt.
 
But a prominent national expert, recently retired Medicare chief actuary Rick Foster, said the report does "a credible job" of estimating potential enrollment and costs under the law, "without trying to tilt the answers in any particular direction."
 
"Having said that," Foster added, "actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully." Actuaries use statistics and economic theory to make long-range cost projections for insurance and pension programs sponsored by businesses and government. The society is headquartered near Chicago.
 
Kristi Bohn, an actuary who worked on the study, acknowledged it did not attempt to estimate the effect of subsidies, insurer competition and other factors that could mitigate cost increases. She said the goal was to look at the underlying cost of medical care.
 
"Claims cost is the most important driver of health care premiums," she said.
 
"We don't see ourselves as a political organization," Bohn added. "We are trying to figure out what the situation at hand is."
 
On the plus side, the report found the law will cover more than 32 million currently uninsured Americans when fully phased in. And some states - including New York and Massachusetts - will see double-digit declines in costs for claims in the individual market.
 
Uncertainty over costs has been a major issue since the law passed three years ago, and remains so just months before a big push to cover the uninsured gets rolling Oct. 1. Middle-class households will be able to purchase subsidized private insurance in new marketplaces, while low-income people will be steered to Medicaid and other safety net programs. States are free to accept or reject a Medicaid expansion also offered under the law.
 
Obama has promised that the new law will bring costs down. That seems a stretch now. While the nation has been enjoying a lull in health care inflation the past few years, even some former administration advisers say a new round of cost-curbing legislation will be needed.
 
Bohn said the study overall presents a mixed picture.
 
Millions of now-uninsured people will be covered as the market for directly purchased insurance more than doubles with the help of government subsidies. The study found that market will grow to more than 25 million people. But costs will rise because spending on sicker people and other high-cost groups will overwhelm an influx of younger, healthier people into the program.
 
Some of the higher-cost cases will come from existing state high-risk insurance pools. Those people will now be able to get coverage in the individual insurance market, since insurance companies will no longer be able to turn them down. Other people will end up buying their own plans because their employers cancel coverage. While some of these individuals might save money for themselves, they will end up raising costs for others.
 
Part the reason for the wide disparities in the study is that states have different populations and insurance rules. In the relatively small number of states where insurers were already restricted from charging higher rates to older, sicker people, the cost impact is less.
 
"States are starting from different starting points, and they are all getting closer to one another," said Bohn.
 
The study also did not model the likely patchwork results from some states accepting the law's Medicaid expansion while others reject it. It presented estimates for two hypothetical scenarios in which all states either accept or reject the expansion.
 
Larry Levitt, an insurance expert with the nonpartisan Kaiser Family Foundation, reviewed the report and said the actuaries need to answer more questions.
 
"I'd generally characterize it as providing useful background information, but I don't think it's complete enough to be treated as a projection," Levitt said. The conclusion that employers with sicker workers would drop coverage is "speculative," he said.
 
Another caveat: The Society of Actuaries contracted Optum, a subsidiary of UnitedHealth Group, to do the number-crunching that drives the report. United also owns the nation's largest health insurance company. Bohn said the study reflects the professional conclusions of the society, not Optum or its parent company.
 
---
 
Online:
 
Society of Actuaries -- http://www.soa.org/NewlyInsured/

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Sebelius: Some Could See Insurance Premiums Rise (Really? You don't say...)
The Wall Street Journal ^ | 3/26/2013
Posted on March 26, 2013 8:36:06 PM EDT by markomalley

Some people purchasing new insurance policies for themselves this fall could see premiums rise because of requirements in the health-care law, Health and Human Services Secretary Kathleen Sebelius told reporters Tuesday.

Ms. Sebelius’s remarks come weeks before insurers are expected to begin releasing rates for plans that start on Jan. 1, 2014, when key provisions of the health law kick in. Premiums have been a sensitive subject for the Obama administration, which is counting on elements in the health law designed to increase competition among insurers to keep rates in check. The administration has pointed to subsidies that will be available for many lower-income Americans to help them with the cost of coverage.

The secretary’s remarks are among the first direct statements from federal officials that people who have skimpy health plans right now could face higher premiums for plans that are more generous. She noted that the law requires plans to provide better benefits and treat all customers equally regardless of their medical claims.

(Excerpt) Read more at blogs.wsj.com ...

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Moen retirees to lose health care insurance
Chronicle Telegram ^ | 3/26/13 | Steve Fogarty
Posted on March 26, 2013 8:27:46 AM EDT by EBH

Judy Starcovic was one of nearly 230 Moen Inc. retirees who opened letters last week informing them their company-provided health care insurance will end as of Jan. 1, 2014.

“I was there 35 years and they told me I had health care with them,” Starcovic, 71, said Monday.

The letter, which was signed by Moen President David Lingafelter, informed retirees that as of Jan. 1, Moen will no longer offer health care insurance to approximately 440 retirees in the U.S., including the almost 230 who live in Northeast Ohio and the rest of the state, according to Robyn Hill, Moen vice president of human resources.

Hill cited the cost of insurance, coupled with adapting the company’s health care to conform to changes mandated by the health care reform bill for its current workers as the reason for the change. Those moves include extending the coverage to age 26 for dependents and paying 100 percent coverage for birth control.

(Excerpt) Read more at chronicle.northcoastnow. com ...

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By: John Hayward 
3/27/2013 07:46 AM

RESIZE: AAA

http://www.humanevents.com/2013/03/27/hhs-secretary-finally-admits-obamacare-is-raising-insurance-costs




A watershed moment in the ongoing disaster of ObamaCare, as Health and Human Services Secretary Kathleen Sebelius finally admits that health insurance premiums are rising because of the President’s health insurance takeover, per the Wall Street Journal:
 

Ms. Sebelius’s remarks come weeks before insurers are expected to begin releasing rates for plans that start on Jan. 1, 2014, when key provisions of the health law kick in. Premiums have been a sensitive subject for the Obama administration, which is counting on elements in the health law designed to increase competition among insurers to keep rates in check. The administration has pointed to subsidies that will be available for many lower-income Americans to help them with the cost of coverage.
 
The secretary’s remarks are among the first direct statements from federal officials that people who have skimpy health plans right now could face higher premiums for plans that are more generous. She noted that the law requires plans to provide better benefits and treat all customers equally regardless of their medical claims.
 
“These folks will be moving into a really fully insured product for the first time, and so there may be a higher cost associated with getting into that market,” she said. “But we feel pretty strongly that with subsidies available to a lot of that population that they are really going to see much better benefit for the money that they’re spending.”
 
Ms. Sebelius added that those customers currently pay more for their health care if their plans have high out-of-pocket costs, high deductibles or exclude particular types of coverage, such as mental health treatment. She also said that some men and younger customers could see their rates increase while women and older customers could see their rates drop because the law restricts insurers’ ability to set rates based on age and gender.
 
Don’t worry, folks, ObamaCare is blowing premiums through the roof, but there will be subsidies available for lower-income Americans!  That means the rest of us will get screwed twice - once when we pay our higher insurance premiums, then again when we pay for all those lovely subsidies.
 
On the political front, Obama’s cherished young voters are getting rooked, but luckily they tend to be low-information types who don’t hold him accountable for anything – they keep saying jobs and economic growth are their top concern, but they voted to re-elect him, didn’t they?  And Sebelius is doing her best to mitigate political fallout from sticker-shocked young people by keeping that “War on Women” narrative going.  Those brutish misogynist ObamaCare opponents just want to repeal the President’s magical program because they want insurance companies to be able to discriminate against women!
 
Sebelius also put some effort into attacking a Society of Actuaries study that predicted an average 32 percent increase in the cost of claims paid out by insurance companies, thanks to the new regulations requiring them to cover people with pre-existing conditions.  The effect will be felt unevenly by various states, with the “overwhelming majority” on track for “double-digit increases in their individual health insurance markets,” while a few are expected to see cost reductions.  Sebelius tried the same tactic of hiding the corresponding increase in premiums by folding them into the immense red inkblot of general federal taxation and spending:
 

The Obama administration challenged the design of the study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law, such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick.
 
The study also doesn’t take into account the potential price-cutting effect of competition in new state insurance markets that will go live Oct. 1, administration officials said.
 
At a White House briefing Tuesday, Health and Human Services Secretary Kathleen Sebelius said some of what passes for health insurance today is so skimpy it can’t be compared to the comprehensive coverage available under the law. “Some of these folks have very high catastrophic plans that don’t pay for anything unless you get hit by a bus,” she said. “They’re really mortgage protection, not health insurance.”
 
Sebelius said the picture on premiums won’t start coming into focus until insurers submit their bids. Those results may not be publicly known until late summer.
 
It’s cute when these people pretend to care about the deficit in order to beat tax increases out of us, isn’t it?  But when multi-trillion-dollar government programs need even more taxpayer subsidies to function, we’re not supposed to bat an eye.  How many “sequesters” will these subsidies be worth over the next decade?  Because when the government is asked to spend $80 billion less in the coming year, it’s a world-ending crisis that causes the entire federal system to tremble on the verge of collapse.
 
Remember back when Barack Obama was lying through his teeth and promising you could keep your plan, if you liked your plan?  Well, his Health and Human Services commissar thinks your skimpy high-catastrophic hit-by-a-bus plan sucks, so it’s dead.  Welcome to socialist reality, suckers.  Just wait until you find out what other promises won’t be kept, like maybe those promises of huge federal subsidies for state Medicaid expansion.
 
There could be even more taxpayer subsidies on the way, because the Financial Times reported on Tuesday that the US Chamber of Commerce is “appealing to the Obama Administration to grant special relief to employers in states that are rejecting federal aid promised under the President’s health reform program.”
 

In states that are not expanding Medicaid, employers will have to pay $3,000 for each employee who joins a state exchange programme to buy health insurance.
 
In a filing this month, the US Chamber of Commerce urged the administration to exempt employers in those states from the tax penalties.
 
In doing so, the chamber pointed to a decision by the Obama administration to exempt poor people in states that do not expand Medicaid from the “individual mandate”, which requires people to get health insurance or face an individual tax penalty. The chamber said the same approach should be used for employers.
 
“If an employer penalty is only triggered by a would-be Medicaid eligible employee, that trigger should be exempted or excused,” the Chamber of Commerce said.
 
The additional cost to employers in states that do not expand Medicaid has been estimated as $1.3 billion a year.  Of course, if Medicaid is expanded, that’s another fleecing for we, the taxpaying sheep.  If we’re going to get our pockets picked anyway, subsidizing businesses sounds like it would be cheaper.  And that’s what waiving the notorious “individual mandate” or business mandates amounts to, because the purpose of those mandates is to force every American to buy health insurance right away, rather than waiting until they get sick and invoking that “must cover pre-existing conditions” mandate.
 
Governor Rick Perry of Texas, which is resisting Medicaid expansion, made this point through a spokeswoman: “This is not free money from the federal government – it’s either being borrowed from China or taken out of taxpayers’ pockets.  The state and federal government can’t afford the current Medicaid program as is, and it’s financially irresponsible to continue expanding a program that we know to be broken.”
 
Who knew all these mandates would be so expensive?  Oh, that’s right: ObamaCare critics, the most thoroughly vindicated group in modern American political history.



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http://news.yahoo.com/little-hope-seen-millions-priced-health-overhaul-213934894--business.html

By Tom Brown
 
MIAMI (Reuters) - Millions of Americans will be priced out of health insurance under President Barack Obama's healthcare overhaul because of a glitch in the law that adversely affects people with modest incomes who cannot afford family coverage offered by their employers, a leading healthcare advocacy group said on Tuesday.
 
Tax credits are a key component of the law and the White House has said the credits, averaging about $4,000 apiece, will help about 18 million individuals and families pay for health insurance once the Affordable Care Act takes full effect, beginning in January 2014.
 
The tax credits are geared toward low and middle-income Americans who do not have access to affordable health insurance coverage through an employer. The law specifies that employer-sponsored insurance is affordable so long as a worker's share of the premium does not exceed 9.5 percent of the worker's household income.
 
In its rule making, or final interpretation of the law, the IRS said affordability should be based strictly on individual coverage costs, however.
 
That means that, even if family coverage through an employer-based plan far exceeds the 9.5 percent cutoff, workers would not be eligible for the tax credits to help buy insurance for children or non-working dependents.
 
"It's an issue. It needs to be fixed," Ron Pollack, executive director of Families USA, an influential healthcare advocacy group said on Tuesday, referring to what he called "the family glitch problem."
 
He spoke on a teleconference calling attention to a report, released by his organization on Tuesday, that said more than 1.7 million Floridians will be eligible for the new premium tax credits next year.
 
'TEA PARTY INFUSION'
 
"The tax credit subsidies are a game changer. They will help make health coverage affordable for huge numbers of uninsured families in Florida who would have been priced out of the health coverage and care they need," Pollack said.
 
He had no estimate for the number of people in Florida affected by the affordability question and IRS policy. But he said there was little hope for a legislative fix in Congress, where the House is controlled by Republicans still bent on repealing Obamacare.
 
The problem comes on top of another more contentious healthcare issue in Florida, where the state legislature has opposed Republican Governor Rick Scott's endorsement of an expansion of Medicaid. Without the expansion, envisioned under Obama's 2010 reforms, Pollack said about 1.8 million Floridians would be left without healthcare coverage.
 
"It would mean that the poorest of the poor really would be left out in the cold," he said.
 
Pollack was joined on the teleconference by Florida Representative Debbie Wasserman Schultz, a congressional champion of healthcare reform who also chairs the Democratic National Committee.
 
"I think one only has to look at the budget the Republicans crammed through the House last week, with the repeal of the Affordable Care Act attached to it, to know that the odds of adding coverage and improving coverage in Obamacare in this Tea Party-infused House of Representatives is very unlikely," she said.
 
"The way to improve this law and to address concerns that have come up with it is not to repeal it, not to throw it out, but to simply make modifications to it. It would be wonderful if we had Republican colleagues in our chamber, on the other side of the aisle, who were willing to sit down and do that."
 
Speaking after the call, Families USA health policy director Kathleen Stoll told Reuters recent studies showed that anywhere between 2 million and 4 million people across the United States would be adversely affected by the federal rule limiting aid and the IRS interpretation of whether an employer's health plan is affordable.
 
"We'd like to see it fixed because it clearly doesn't reflect what Congress intended," Stoll said.
 
"It could mean the difference between being able to move in to purchasing private insurance and not purchasing private insurance. Hopefully within the next couple of years there will be room to fix it."
 
(Reporting by Tom Brown. Editing by Andre Grenon)
.

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American doctors are increasingly concerned about changes already implemented or coming to the health-care system, and some are opting to retire sooner than planned.

Deloitte’s 2013 survey of U.S. physicians found 57% doctors view changes in the industry under the Affordable Care Act as a threat, and six in 10 physicians report it’s likely that many will retire earlier than planned in the next two to three years. This trend could cause more widespread issues in the health-care system that is already coping with doctor and nurse shortages in some areas of the country.

The survey found these numbers to be fairly uniform among all doctors regardless of age, gender or medical specialty.

Fifty-seven percent also say the practice of medicine is in jeopardy, because the “best and brightest” may not consider a career in medicine under new requirements of the reform.

New Jersey-based family physician Marc Mayer, blames the new electronic medical records requirement under the reform as pushing doctors into retirement early. The Patient Protection and Affordable Care Act mandates practices use electronic medical records to reduce paper work, increase communications and cut costs and errors starting Oct. 1 2012.

“Those one and two-person practices with doctors in their late 50s and early 60s may think it’s too daunting of a change and retire early,” he says. “If they don’t do all of those [required] things, they will be looking at a drop in income.”

Jane Orient, executive director of the American Association of Physicians and Surgeons, says the group has been surveying its members on early retirement and other topics for the past decade and has seen similar responses since the implementation of health-care reform. However, she says the economy will play a bigger role on how many doctors exit their practice.

“Some are looking at concierge models, some doctors will go work for hospitals because they just can’t cope with the crushing load of new regulations,” Orient says.

Physicians also report a decrease in take-home pay from 2011 to 2012 in the Deloitte survey, attributing the haircut  to ObamaCare. More than half of respondents saw a 10% or less decrease in their paycheck in the past year. Half forecast that physician incomes will fall dramatically in the next one to three years. Sixty-eight percent of solo physicians report being more likely to have their incomes will fall than those in practices with two to nine physicians (51%) or those with more than 10 physicians (44%).

ObamaCare proposes to save money by “squeezing doctors’ ability to make money,” says Orient.  Right now, about 50% of what doctors make goes to overhead costs, she adds, so a 10% cut in fees at doctors’ offices equates to a 20% cut in profits.

“A lot of our doctors are [concerned about profit loss] and say these threats and cuts are draconian. The requirements are impossible and if you combine that with the fact that a frightening proportion are aged 55 and older, many could retire if they wanted to,” she says.

Mayer’s practice, the Avenel-Iselin Medical Group is a patient-centered medical home, and has been able to participate in both Medicare and private commercial insurance programs. In 2013 and 2014, the law requires states to pay PCPs 100% of Medicare payment rates for services.

“They are paying us for care management fees, and we are now being paid for primary care physician services that we have always done but were never paid for.”

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Study: Obamacare threatens 3.2 million small business jobs

March 22, 2013 | 9:03 am | Modified: March 22, 2013 at 9:05 am
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President Obama at a Five Guys restaurant. AP Photo.
Over one-third of the 9.1 million full-time jobs among America's diverse business franchises could be cut back or eliminated by Obamacare as small businesses struggle to maintain profitability while coughing up money to pay for Washington-mandated health care coverage, according to the International Franchise Association.
 
The threat of hitting 3.2 million full-time workers as the Affordable Care Act takes effect next year is prompting the owners of fast food restaurants, service companies and other franchises to urge Congress to make significant changes in Obamacare.
 
To help their cause, the association on Friday released a new state-by-state breakdown on the potential impact on jobs in the bull's eye of Obamacare, which declares that a 30-hour week is full-time, not the industry accepted 40 hours. That 10-hour difference has thousands of franchise owners scrambling to either fund healthcare for those working 30 hours, or cut hours back to below 30 hours.
 

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"The ACA has made health care an inextricable cost of running a small business in America and continues to evolve with regard to its cost and complexity for franchisees and franchisors as the law becomes fully implemented ahead of 2014," said IFA Senior Vice President of Government Relations & Public Policy Judith Thorman. "Preparing your franchise business to deal with the ACA should be a top priority for franchisees and franchisors."
 
Secrets has interviewed several franchise owners who have said that they are planning to cut hours of workers below 30 hours to avoid either having to provide health care or pay a fine.
 
The new statistics show that California franchises would be hit the hardest. The association said the state is home to 925,000 franchise full-time jobs, and that 324,604 are in jeopardy.
 
The statistics, based on a 2011 Hudson Institute study, also show that the industry could face additional costs of $6.4 billion, most of which would be passed on to consumers. A North Carolina Five Guys burgers franchise owner, for example, recently told Secrets that he is facing added costs of $60,000 a year under Obamacare and that he would have to boost prices of burgers, fries and hot dogs.
 
To help businesses figure out the new and evolving law, the IFA launched a new online educational website, www.MakingSenseofHealthC are.org, that includes tools and information for employers to determine which aspects of the employer mandate they are responsible for complying with and testimonials from franchise industry leaders regarding how they are adjusting their businesses and workforce to comply with the law.
 
Among the changes being urged by the industry is a change from 30 hours to 40 hours for what constitutes a full-time worker.

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Healthcare Law Could Raise Premiums 30% For Some Californians
LATimes ^ | March 28, 2013 | Chad Terhune
Posted on March 30, 2013 3:25:56 PM EDT by Steelfish

Healthcare Law Could Raise Premiums 30% For Some Californians Premiums for many middle-income residents who aren't covered by employer plans could go up an average of 30% next year, a report says. Lower-income consumers could save big.

By Chad Terhune March 28, 2013, 6:24 p.m. About 5 million Californians got a first glimpse at what they might pay next year under the federal healthcare law. For many, that coverage will come with a hefty price tag.

Compared with what individual policies cost now, premiums are expected to rise an average of 30% for many middle-income residents who don't get their insurance through their employers.

Alternatively, lower-income consumers will reap the biggest savings and are projected to save as much as 84% off their coverage thanks to federal subsidies.

The figures were released Thursday by Covered California, the state agency charged with implementing the federal Affordable Care Act. They underscore the harsh reality that costs for some consumers will have to rise in order to carry out the biggest healthcare expansion in half a century.

"It's hard to design any change of this scale where everybody is a winner and no one is worse off," said Gerald Kominski, director of the UCLA Center for Health Policy Research and an expert on health insurance. "Some people will feel they are being unfairly targeted or penalized."

The threat of higher costs could alienate many of the policyholders the state needs to keep in the fold in order to offset the increased costs of covering sicker, poorer people who have been shut out of the system for years.

(Excerpt) Read more at latimes.com ...

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Big Health Insurance CEO Warns Of 'Troubled Times' For Obamacare
 


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 Humana CEO Bruce Broussard runs the fourth-largest health insurance group in America. He has spent more time engaging with the provisions of President Obama's health care reform than just about anybody else. And even he isn't sure what the law's going to look like or what its impact will be over the next 7 years.
 
Broussard told Knowledge@Wharton:
 
"We have not seen all the details around health care reform. The implementation is going to be at the end of the year. In fact, people will probably start buying [insurance] in the fourth quarter or so. We are asking for some more detail. The second aspect is that it is such a complicated bill. There are so many interrelated details that I don't think anyone knows all the different parts. Our concern is about what we don't know."
 
Broussard expects prices to to go up, particularly for the young healthy population. That's a fact that hasn't totally sunk in for the public and businesses, which worries the Humana CEO.
 
"I don't think it's been talked about enough in public. I think the communication of the reform has been around the expansion of the coverage. But I do not see a real, large conversation around what the impact is on the public."
 
He calls pricing the biggest issue, and says that we can expect a "bumpy road" until the details get hashed out. And there are lots of details.
 
There's also uncertainty about what health care exchanges — a set of regulated and standardized health care plans which can be federally subsidized — will look like. Some will be run by states, some in partnership with the government, meaning there could be wide variety of different rules.
 
They're supposed to be up and running by January 1st, 2014, but Broussard says there's still a tremendous amount of detail to be worked out, which could cause delays.
 
The hospital industry has already massively consolidated ahead of health care changes.
 
Other businesses, however, are unprepared. After all, there has been little discussion of the impact since the Supreme Court upheld the law.
 
In the long run, Broussard expects that the law and technology will work to reduce cost long term. But for now, we can expect "troubled times."


Read more: http://www.businessinsider.com/businesses-uncertain-about-obamacare-2013-4#ixzz2PFGO2DHN

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Small Firms’ Offer of Plan Choices Under Health Law Delayed
 
By ROBERT PEAR
 
Published: April 1, 2013 419 Comments
 

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WASHINGTON — Unable to meet tight deadlines in the new health care law, the Obama administration is delaying parts of a program intended to provide affordable health insurance to small businesses and their employees — a major selling point for the health care legislation.



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The law calls for a new insurance marketplace specifically for small businesses, starting next year. But in most states, employers will not be able to get what Congress intended: the option to provide workers with a choice of health plans. They will instead be limited to a single plan.

The choice option, already available to many big businesses, was supposed to become available to small employers in January. But administration officials said they would delay it until 2015 in the 33 states where the federal government will be running insurance markets known as exchanges. And they will delay the requirement for other states as well.

The promise of affordable health insurance for small businesses was portrayed as a major advantage of the new health care law, mentioned often by White House officials and Democratic leaders in Congress as they fought opponents of the legislation.

Supporters of the law said they were disappointed by the turn of events.

The delay will “prolong and exacerbate health care costs that are crippling 29 million small businesses,” said Senator Mary L. Landrieu, Democrat of Louisiana and the chairwoman of the Senate Committee on Small Business and Entrepreneurship.

In the weeks leading up to the passage of the health care legislation in 2010, Ms. Landrieu provided crucial support for the measure, after securing changes to help small businesses.

The administration cited “operational challenges” as a reason for the delay. As a result, it said, most small employers buying insurance through an exchange will offer a single health plan to their workers next year.

Health insurance availability and cost are huge concerns for small businesses. They have less bargaining power than large companies and generally pay higher prices for insurance, if they can afford it at all.

The 2010 law stipulates that each state will have a Small Business Health Options Program, or SHOP exchange, to help employers compare health plans and enroll their employees.

One of the most important tasks of the exchange is to simplify the collection and payment of monthly premiums. An employer can pay a lump sum to the exchange, which will then distribute the money to each insurance company covering its employees.

The Obama administration told employers in 2011 that the small business exchange would “enable you to offer your employees a choice of qualified health plans from several insurers, much as large employers can.” In addition, it said, the exchange would “consolidate billing so you can offer workers a choice without the hassle of contracting with multiple insurers.”

Exchanges are scheduled to start enrolling people on Oct. 1, for coverage that begins in January. However, the administration said that the government and insurers needed “additional time to prepare for an employee choice model” of the type envisioned in the law signed three years ago by President Obama.

D. Michael Roach, who owns a women’s clothing store in Portland, Ore., said the delay was “a real mistake.”

“It will limit the attractiveness of exchanges to small business,” he said. “We would like to see different insurance carriers available to each of our 12 employees, who range in age from 21 to 62. You would have more competition, more downward pressure on rates, and employees would be more likely to get exactly what they wanted.”

John C. Arensmeyer, the chief executive of Small Business Majority, an advocacy group, said that the delay of “employee choice” was “a major letdown for small business owners and their employees.”

“The vast majority of small employers want their employees to be able to choose among multiple insurance carriers,” Mr. Arensmeyer said.

Small Business Majority supported Mr. Obama’s health care law.

That support was invaluable to Democrats who pushed the bill through Congress. Representative Nancy Pelosi of California, who was speaker at the time, cited the group’s research as evidence that “small businesses will benefit from health insurance reform.”

However, in recent weeks, insurance companies urged the administration to delay the employee choice option.

“Experience with Massachusetts has demonstrated that employee choice models are extremely cumbersome to establish and operate,” the health insurer Aetna said in a letter to the administration in December.

Insurers said that the administration was partly responsible for the delay because it did not provide detailed guidance or final rules for the small-business exchange until last month.

Businesses with up to 100 employees will be able to buy insurance in the exchanges. In 2014 and 2015, states can limit participation to businesses with 50 or fewer employees. Companies with fewer than 25 workers may be able to obtain tax credits for up to two years of coverage bought through an exchange. States can open the exchanges to large employers in 2017.

A few states running their own exchanges, including California and Connecticut, said they planned to offer an employee choice option next year, though it was not required by the federal government.

A stated goal of the 2010 law was to increase “consumer choice” and stimulate competition among insurers.

The law makes it easier for consumers to compare health plans by defining four standard levels of coverage, ranging from the least to the most generous. The law says an employer can pick a level of coverage and then allow employees to choose among all the health plans available at that level.

Soul Crusher

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http://swampland.time.com/2013/04/02/obamacare-incompetence


bbbooommmmmm


Total FAIL by Choom Wagon in Chief

GigantorX

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Mine didn't go up or down.  However, i have friends in the medical industry and they are starting to hear of rumors of downsizing as a result of Obamacare.

So until there are actual reports with actual numbers........  ::)

"Medical Devices?"

If so, I'm in that field and it isn't looking good, at least at the moment.

The Device Tax of 2.5%~, in a lot of cases, cannot be passed along to the hospitals/medical centers etc. Health systems are actually sending out notices to companies that they will not accept the passing along of cost. So the companies have to eat it which carries with it all sorts of poor outcomes. 2.5%~ in a highly competitive industry is nothing to laugh at or dismiss. It's serious.

This "Affordable Care" law is looking more and more like a convoluted, indecipherable, bloated and harmful mess.