Forbes: GOP’s Dave Camp: Why Not Put All Federal Employees Onto Obamacare’s Exchanges?

WASHINGTON, DC - DECEMBER 20:  U.S. Rep. Dave ...

In response to this week’s brouhaha regarding attempts by members of Congress to avoid having to enroll themselves and their staff members in Obamacare’s health insurance exchanges, Michigan Republican Dave Camp, Chairman of the House Ways and Means Committee, has offered a new proposal: Why not put all federal employees on the exchanges? It’s an attractive idea, but it has some downside: it would dismantle a popular model of market-based health reform.

“If the ObamaCare exchanges are good enough for the hardworking Americans and small businesses the law claims to help, then they should be good enough for the president, vice president, Congress, and federal employees,” said Camp’s spokeswoman in a statement.

The political principle is straightforward, but it would come at a price. Putting all federal employees on the exchanges would obliterate the most market-oriented insurance program run by the government, the Federal Employee Health Benefits Program, or FEHBP. Indeed, the FEHBP has long been considered a model for market-based reform of the Medicare and Medicaid programs.

In the FEHBP, employees get to choose amongst a wide variety of plans offered by private insurers. The employer–the government–then subsidizes about three-fourths of the cost to the employee. The employee can choose a more generous or expensive plan if he wants, but he has to pay for a portion of the difference in price, and vice versa. As a result of this approach, FEHBP plans have organically evolved to contain the benefits and financial features that consumers want. By contrast, any minor change to Medicare requires an act of Congress.

Obamacare’s exchanges are closer in concept to FEHBP than traditional Medicare, but the exchanges heavily constrain the ability of plans to alter their design as consumers’ preferences evolve.

Click below for the full article.

http://www.forbes.com/sites/aroy/2013/04/26/gops-dave-camp-why-not-put-all-federal-employees-onto-obamacares-exchanges/

 

Forbes: Doctors Rush To Obamacare’s Accountable Care Approach

The number of physicians participating in the emerging medical care delivery system known as “accountable care organizations” (ACOs) has tripled as the health care industry moves further away from fee-for-service medicine.

A new study from Medscape said one in four doctors, or 24 percent, “were either in an ACO or planned to be in an ACO within a year.” By comparison, only 8 percent of physicians in Medscape’s 2012 report were in or planning to be in an ACO. The report included more than 21,000 doctor respondents across 25 specialties.

Click below for the full article.

http://www.forbes.com/sites/brucejapsen/2013/04/27/doctors-rush-to-obamacares-accountable-care-approach/?partner=yahootix

Motley Fool: Do These Obamacare Winners Look Like Losers Now?

Have the Obamacare winners become losers? When the Patient Protection and Affordable Care Act, or PPACA, was first passed, most analysts pegged hospital systems as obvious winners from the new law. That viewpoint also held true last year as the Supreme Court upheld much of Obamacare.

The stock market clearly agreed. Immediately after the Supreme Court decision, hospital stocks surged. Community Health Systems  (NYSE: CYH  )  jumped 8%. Health Management Associates  (NYSE: HMA  )  shares rose 7%. The largest private hospital chain, HCA Holdings  (NYSE: HCA  ) , soared by 10%.

Since the high court ruling, few sectors have performed as well as hospitals have. Community Health Systems shares rose as much as 88% by late March. Likewise, HMA stock nearly doubled. HCA shares rose more than 50% during the same period. No hospital stock performed better than Tenet Healthcare  (NYSE: THC  ) , though. Tenet’s shares skyrocketed 140%.

That was then. The performance of these stocks in the month of April thus far tells a much different tale.

Spring backwards? Community Health Systems shares are down almost 13% since the beginning of April. HMA isn’t far behind, with shares falling 12%. HCA stock has dropped 7.5%. What about the biggest winner: Tenet? It’s now the biggest loser, with shares plunging more than 16% this month. Has the luster of Obamacare worn off?

Many hospitals wanted the ACA to succeed. The industry’s lobbying organization, the American Hospital Association, actively supported the legislation and even submitted an amicus brief to the Supreme Court in support of the individual mandate.

The primary reason behind support for the bill stemmed from the prospects of millions of currently uninsured Americans gaining insurance. Many hospitals must write off large amounts of money when individuals with no insurance cannot pay for the care provided. If more people gain insurance under Obamacare, hospitals hope that these write-offs will decrease significantly.

However, many currently uninsured Americans could choose to pay fines rather than obtain insurance. If this scenario becomes widespread, the benefits to hospitals could be dampened.

Others suspect that the costs of the ACA could minimize the advantages for hospitals. Bob Kirby, a director with Fitch Ratings, said last year that “it is unclear if the incremental revenue generated from increased utilization and lower levels of uncompensated care will offset the potential compression in margins.”

All in the timing Obamacare’s timing could also be problematic. Even if millions of uninsured Americans buy insurance as hoped for, that scenario won’t happen until 2014. In the meantime, hospitals are dealing with some of the challenges of the ACA.

Click below for the full article.

http://money.usnews.com/money/blogs/planning-to-retire/2013/04/26/what-gen-x-doesnt-know-about-social-security

Forbes: Congress Seeks to Opt Out of Participating in Obamacare’s Exchanges

As Obamacare was winding its way through the Senate in 2009, Sen. Chuck Grassley (R., Iowa) slipped in an amendment requiring that members of Congress, and their staff, enroll in Obamacare’s health insurance exchanges. The idea was simple: that if Congress was going to impose Obamacare upon the country, it should have to experience what it is imposing firsthand. But now, word comes that Congress is quietly seeking to rescind that provision of the law, because members fear that staffers who face higher insurance costs will leave the Hill. The news has sparked outrage from the right and left. Here’s the back story, and why this debate is crucial to the future of market-based health reform.

Sen. Grassley’s original idea was to require all federal employees to enroll in the exchanges, instead of in the Federal Employee Health Benefits Program, where most gain coverage today. Indeed, a previous Senate Finance Committee amendment proposed putting members and staffers on Medicaid. But “fierce opposition from federal employee unions” sank Grassley’s effort, and he had to water his amendment down to only apply to Congress and congressional staff.

Staffers grumble about being stuck on the exchanges

Ever since Obamacare became law, this has been a source of grumbling among the congressional staffers I talk to. One aspect of the Grassley amendment is that it originally appeared to exempt staffers who worked for congressional committees, and congressional leadership, because those staffers didn’t work for specific Members of Congress. (My understanding is that the Office of Personnel Management has since clarified the regulations to include all staff, including committee and leadership.)

It is always fascinating when politicians pass unconstitutional laws that are supposedly good enough for the people but not good enough for them.  Click below for the full article.

http://www.forbes.com/sites/aroy/2013/04/25/congress-fearing-brain-drain-seeks-to-opt-out-of-participating-in-obamacares-exchanges/?partner=yahootix

Forbes: Big Brother Has A New Face, And It’s Your Boss

Recently, the CVS Caremark Corporation began requiring employees to disclose personal health information (including weight, blood pressure, and body fat levels) or else pay an annual $600 fine. Workers must make this information available to the company’s employee “Wellness Program” and sign a form stating that they’re doing so voluntarily.

CVS argues this will help workers “take more responsibility for improving their health.” At one level, this makes a certain sense. Because the company is paying for their employees’ health insurance, they naturally prefer healthier workers. But at a deeper level, CVS’ action demonstrates a growing problem with our current system of employer-provided health insurance. If our bosses must pay for our health care, they will inevitably seek greater control over our lifestyles.

Although most Americans take it for granted that they receive health insurance through the workplace, this is an artifact of federal tax rules from World War II. When the U.S. government imposed wartime wage controls, employers could no longer compete for workers by offering higher salaries. Instead, they competed by offering more generous fringe benefits such as health insurance. In 1943, the IRS ruled that employees did not have to pay tax on health benefits provided by employers; in 1954, the IRS made this permanent.

The federal government thus distorted the health insurance market in favor of employer-based plans. If a company paid $100 for health insurance with pre-tax dollars, the employee enjoyed the full benefit. But if the employee received that $100 as salary, he could only purchase $50-70 of insurance after taxes. Over time, this tax disparity helped employer-based health insurance dominate the private insurance market. In 2008, over 90% of non-elderly Americans with private insurance received it through their workplace.

Hence, government policy artificially injects the employer into the relationship between a patient and the health insurance system. Normally, what a worker ate or whether he smoked at home would be of no concern to his boss (unless it affected job performance). But U.S. government policy makes it the employer’s business.

To make matters worse, ObamaCare reinforces this status quo. ObamaCare requires large employers to offer health insurance to workers (or else pay a penalty). As a result, more people are discussing how best to link employment to healthy behavior. For example, the New England Journal of Medicine recently featured a pair of high-profile editorials debating the merits of allowing companies to discriminate against smokers, “for their own good.”

Furthermore, ObamaCare pays government grants to encourage companies to implement these “wellness programs.” Hence, employers who wouldn’t otherwise concern themselves with workers’ lifestyles now have an incentive to do so in order to collect federal funds.

This is very well written and informative article.  For those that wonder why employers are involved in health insurance (and not home owners insurance, car insurance, etc.) it was simply because of government intervention.  Salary freezes caused the creation of “benefit packages.”

What do you think about government intervention like price freezes and the constitutionality of them?  Click below for the full article.

http://www.forbes.com/sites/paulhsieh/2013/04/25/big-brother-has-a-new-face-and-its-your-boss/

Washington Post: Governments may push workers out of employer health care and into health exchange

In a quest to save money, political leaders in Washington state are exploring a proposal that would shift some government workers out of their current health plans and onto the insurance exchange developed under President Barack Obama’s health care law.

Lawmakers believe the change, which could affect thousands of part-time state employees and education workers, would save the state $120 million over the next two years. It would consequently push more health care costs onto the federal government because many of the low-income workers would likely qualify for federal subsidies.

Washington state appears to be the first major government to seriously explore the possibility of pushing public employees into the exchange, but it probably won’t be the last. Rick Johnson, who advises state and local governments on health care policy at the New York-based consulting firm Segal Company, said he expects it will be an option some state and local governments will explore in the years to come.

“I can see that as one of the solutions out there,” Johnson said.

A spokeswoman with the Department of Health and Human Services declined comment.

Because the federal law requires employers to provide coverage for those working at least 30 hours a week, states are exploring various ways to manage their part-time employees.

Click below for the full article.

http://www.washingtonpost.com/business/governments-may-push-workers-out-of-employer-health-care-and-into-health-exchange/2013/04/24/fed10f26-acb4-11e2-9493-2ff3bf26c4b4_story.html

Reuters: Catholic Church withdraws subpoena to Obama on birth control

Scaling down a legal fight with the White House, the Roman Catholic Archdiocese of New York has agreed to drop a request for documents about the government’s requirement of insurance coverage for birth control, a court filing on Monday said.

The archdiocese sent a subpoena to President Barack Obama’s administration in February asking for documents from White House staff, including Obama himself, for use in a church lawsuit against the contraception mandate.

Citing the burden involved and calling a subpoena of the president’s office inappropriate, the White House asked a federal judge to toss out the subpoena on April 4.

A notice filed in U.S. District Court in Washington late on Monday said the archdiocese agreed to withdraw its subpoena. It did not say why.

A lawyer for the archdiocese declined to comment on Tuesday. A spokeswoman for the U.S. Justice Department, which represented the White House in court, had no immediate comment.

Click below for the full article.

http://www.reuters.com/article/2013/04/23/us-usa-courts-obama-idUSBRE93M17H20130423

The Motley Fool: Obamacare and Sequestration Crush UnitedHealth

In this video, health-care analyst David Williamson discusses how Obamacare and sequestration are weighing on shares of insurer UnitedHealth (NYSE: UNH) . David breaks the managed care company’s quarter into Clint Eastwood-inspired good, bad, and ugly segments, helping investors in UnitedHealth, and related stocks, to find out everything they need to know from this bellwether’s earnings, and what to expect going forward.

When President Obama was re-elected, shares of UnitedHealth and other health insurers fell immediately. Is Obamacare a death knell for health insurers, or is the market missing out on some of the opportunities the law presents? In this brand new premium report on UnitedHealth, The Motley Fool takes a long term view, honing in on prospects for UnitedHealth in a post-Obamacare world. So don’t miss out — simply click here now to claim your copy today.


Click below for the full article.

http://www.fool.com/investing/general/2013/04/19/obamacare-and-sequestration-crush-unitedhealth.aspx

CNBC Guide to Obamacare for Small Businesses

Even as you finish with this year’s taxes, if you’re a small-business owner experts say it’s time to look ahead to 2014, when the tax implications of the Affordable Care Act (ACA) begin to kick in.

“Just now, things are really sinking in that there is this employer responsibility,” said Amanda Austin, of the National Federation of Independent Business.

Under ACA, often called Obamacare, employers with 50 or more full-time workers face a mandate to provide insurance. It’s known formally as shared responsibility.

“You’re going to need somebody to do a thorough review of the impact on your business,” Austin said, because the new rules are complex.

For the complete article including more on the 50/30 rule, click the link below.

http://www.cnbc.com/id/100641995