Coverage of the president's signature legislative accomplishment has taken a back seat to other issues and international events in early 2015, but -- as expected
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Although the Affordable Care Act has not led to soaring insurance costs, as many critics claimed it would, the law hasn't provided much relief to American workers either, according to a new study of employer-provided health benefits. Workers continue to be squeezed by rising insurance costs, eroding benefits and stagnant wages, the report from the nonprofit Commonwealth Fund found. Nationwide, the average contribution an employee made to an insurance premium in 2013 and the average deductible together represented 9.6% of the median income of American households with members under age 65. That is up from 8.4% in 2010 and nearly double the 5.3% that households were paying for employer-provided health coverage in 2003. "Workers are paying more but getting less protective benefits," the report's authors noted.
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First off, contra that opening sentence, premiums have soared by double digits for many consumers. And crippling deductibles, plus access shock, have stymied a large number of "Affordable" Care Act "beneficiaries." (Remember, the number one reason why a giant chunk of uninsured Americans are choosing to eschew purchasing new coverage is that they can't afford the rates). To the extent that rate increases are relatively modest, a major explanatory factor are those "three R's" gimmicks, including effective bailouts to insurance companies, which are scheduled to sunset in fairly short order. Also, "slowing" cost increases are still increases -- and have been largely attributed to the lackluster economy, rather than the law. Regardless, the report notes that average people are forking over more of their hard-earned money to pay for their healthcare today than they were when Obamacare passed. That is an unmitigated failure, based on the whole premise of the law. Also, national healthcare spending is still increasing, not decreasing. The "cost curve down" pledge was a fantasy. Oh, and have fun this tax season, America. Meanwhile, out in California:
California's budget, which bounced back after years of deficits, is now being squeezed by rising healthcare costs for the poor and for retired state workers. The mountain of medical bills threatens to undermine Gov. Jerry Brown's efforts to strengthen state finances — his central promise of the past four years. Enrollment in the state's healthcare program for the poor, known as Medi-Cal, has exploded by 50% since President Obama's signature law took effect. Although the federal government picks up most of the tab, state costs have also been growing, and faster than expected...Over the next year, total Medi-Cal enrollment is expected to reach 12.2 million, he said — about one-third of the state's population. It was less than 8 million in 2013. Even though costs are increasing, advocates for the poor say the state has not allocated enough money to provide healthcare to those who are still struggling years after the recession. Payments for Medi-Cal services were reduced during years of budget crises, making doctors more reluctant to participate in the program.
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Lots of bolded text in that excerpt, and for good reason: It encapsulates many of the huge headaches frequently ignored by advocates of Obamacare's Medicaid expansion. In addition to Medicaid not delivering any discernible advantage in health outcomes for its enrollees compared to uninsured people (!), here we see the program's massive expansion crushing one large state's budget. Costs are increasing faster than expected, and reimbursement cuts are scaring off doctors (thus reducing access to care for program participants). The article mentions that the federal government "picks up most of the tab," but Uncle Sam's generosity "phases down" over time, which will require participating states to scramble to make up the difference. And despite the exploding costs and obligations, "advocates for the poor" still complain that the government's stretched resources aren't sufficient. Astoundingly, roughly one in three citizens of America's most populous state is now on the rolls of the state's government-run healthcare program, up dramatically from just two years ago. More people dependent on government. More people shunted into a failing program that was already overburdened prior to their arrival. And fewer doctors willing to accept the paltry government rates. In what way is this "compassionate"? I'll leave you with a link to Philip Klein's new book about how to uproot and replace this entire law. Conn
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