Obamacare News of the Day

The Federalist: Obama's Census Bureau Officially Plans To Cook Obamacare's Books

• The New York Times reported…that the U.S. Census Bureau planned to radically alter its method of calculating the number of people without health insurance in the U.S. The result? The changes will be so radical that “it will be difficult to measure the effects of President Obama’s health care law in the next report, due this fall, census officials said.”
• You know what else is due this fall? A big election in which the effects of Obamacare are sure to weigh on voters’ minds. Don’t worry, though. Census officials said the timing of the change was “coincidental” and “unfortunate.” The latter is most certainly the case, but unfortunate for whom? Certainly not the White House, which mere days ago was bragging, Mission Accomplished-style, about how amazing the Obama implementation was going.
• [Census officials and researchers had previously expressed concerns about the old questionnaire method and said it was "an inflated estimate of the uninsured" and prone to "measurement errors]…So not only will the new numbers be close to useless when it comes to using them to figure out if Obamacare has had its intended effect, it turns out the old numbers — which the White House used to cram the law down America’s throat — were bogus as well. Heads they win, tails you lose.
• Nothing says “confidence in victory” like unilaterally altering the strike zone in the ninth inning and then hiding the scoreboard just to be safe.
• [RELATED] Wall Street Journal: Cooking the ObamaCare Stats Suddenly, the Census Bureau changes how it counts insurance
  • The FDA would never approve a new drug whose maker completely changed the clinical trial protocol in the middle of the experiment, yet that is what the White House has done. How many people gained or lost insurance under ObamaCare? Did government crowd out individual insurance? What about employer-sponsored insurance? It will be much harder and in some cases impossible to know.
  • As with the IRS targeting of conservative political groups, this sudden change will undermine public trust in the supposedly nonpartisan institutions of government. Muddying a useful source of information about ObamaCare's results is definitely unfortunate, but our guess is that it wasn't coincidental.
• [RELATED] Bloomberg: Is Obama Cooking the Census Books for Obamacare?
  • It’s not that I am opposed to the changes: Everyone understands that the census reports probably overstate the true number of the uninsured, because the number they report is supposed to be “people who lacked insurance for the entire previous year,” but people tend to answer with their insurance status right now.
  • But why, dear God, oh, why, would you change it in the one year in the entire history of the republic that it is most important for policy makers, researchers and voters to be able to compare the number of uninsured to those in prior years? The answers would seem to range from “total incompetence on the part of every level of this administration” to something worse.

Hot Air: CBO: Obamacare premiums and healthcare spending will rise by less than expected, because…

• In a nutshell, the CBO initially made its projections under the assumption that the plans offered through the exchange would be largely similar in terms of benefits to the sorts of plans being offered by employers — but that definitely isn’t going to be the case. The narrowed networks that insurers are using to keep costs down and the lower reimbursement rates for doctors and hospitals are things that neither consumers nor providers tend to like in the long run — which will likely mean more strain on the system and higher costs further down the road.

MadisonCourier.com: 'We'll Get It Fixed' McConnell says he'll fight for changes to Affordable Care Act

• "I think this was a big mistake," McConnell said of the Affordable Care Act. "It was a mistake for healthcare and a big mistake for our country." But the law won't be easily remedied with President Barack Obama in office, he said.
• Obama won't repeal the law, but McConnell said Republican legislators plan to try to push back against the legislation. "We're going to figure out a way to get this fixed," McConnell said. "This isn't going to stay the way it is."

City Journal: The Doctor Won't See You Now Millions may get "insured" through Obamacare, but that doesn't mean they'll be able to see a physician

• …most insurers are offering exchange plans that severely limit the number of doctors and hospitals patients can visit. Some state exchanges—including New York’s—don’t offer a single plan that covers visits to out-of-network doctors or hospitals. Many people will not be able to see the physicians who have treated them for years, use facilities providing the most appropriate treatment, or access care within a reasonable time and distance from their homes. Some specialty hospitals have been excluded from all exchange plans.
• If this scenario sounds familiar, it’s because we’ve seen it before, during the failed managed-care experiment of the 1990s. Patients and physicians quickly became disenchanted with the restrictions and bureaucratic complexity of Health Maintenance Organizations (HMOs). At least patients had options then. They could avoid HMO restrictions by buying broader, more expensive insurance plans. Many plans available now on the state exchanges are highly restrictive, HMO-like networks.
• Patient choice has been further compromised by the haphazard implementation of the exchanges. Patients have reported trouble determining which physicians will participate in which plans. Doctors, too, are often unaware whether they’re listed in particular insurance networks and what the reimbursement rates are. Many find themselves arbitrarily excluded from plans in which they had previously participated; others are getting listed on plans without their knowledge.
• Worst of all, insurance coverage under the ACA is unlikely to improve health outcomes. The much-noted Oregon Medicaid-expansion study found that new Medicaid enrollees showed no improvement in health outcomes compared with the uninsured. Other studies have shown that Medicaid patients have worse outcomes compared with privately insured patients (though why this happens is not well understood). The health outcomes of many exchange patients will suffer as a result of not being able to see their regular physicians or access the most appropriate specialists and hospitals.

Forbes: More Reasons Why IPAB, Obamacare's 'Death Panel,' Is Relevant To Sylvia Burwell's Nomination

• ObamaCare grants IPAB many powers year in and year out. It has an annual budget of more than $15 million, which grows automatically each year. It can hold nationwide hearings on how it (and Congress) should reform health care. It can “secure directly from any department or agency of the United States information necessary” to carry out its duties.
• Starting this July, it must issue annual reports on public- and private-sector health care spending with an eye toward “the proliferation, effectiveness, and utilization of health care technologies, including variation in provider practice patterns and costs,” and “any other areas that the Board determines affect overall spending and quality of care in the private sector.” It must submit annual “advisory reports” to Congress on such matters as how to cut payments to providers who are (supposedly) exempt from IPAB’s powers to cut Medicare payments.
• By 2015, it must produce “advisory recommendations” that, in coordination with its advisory reports, would slow the growth in private health spending. Advisory recommendations can include proposals “that may require legislation to be enacted by Congress…or State or local governments” and “that the Secretary or other federal agencies” – including IPAB – “can implement administratively.” (As Diane Cohen and I explain, IPAB effectively has the power to regulate private health spending as well.)
• Since President Obama has not yet nominated any “appointed” IPAB members and the remaining two ex officio voting members – Centers for Medicare & Medicaid Services administrator Marilyn Tavenner and Health Resources and Services Administration administrator Mary K. Wakefield – would report to the next Secretary of HHS, Burwell would in all likelihood wield all of these IPAB powers herself.