Health Reform: The need for an overhaul of ObamaCare just got more acute, as a new survey shows that satisfaction rates among those enrolled in ObamaCare plans has taken a steep nose-dive this year amid premium hikes and reduced choices.
The new coverage of ObamaCare these days has been all about protests against repeal and the alleged increase in public support for the law.
But a survey of actual ObamaCare customers released this week paints an entirely different picture.
It found that just 22% of the 44,200 ObamaCare enrollees polled rate their health plan as good to excellent. That’s down from 77% who gave their ObamaCare plans high marks last year.
The reason for the sharp decline was higher premiums, worse service and lack of choice. The survey, conducted by Black Book Market Research, found that 96% reported a decline in customer service support, 90% noted premium increases, 80% said their plans had narrower provider networks, and 77% said their plans’ benefits had been trimmed. Nearly two-thirds (61%) complained about lack of competitors in their market.
In other words, the collapse of competition in the ObamaCare exchanges — which left five states and a third of U.S. counties with only one ObamaCare insurer — has led to the rapid deterioration in quality.
Black Book managing partner Douglas Brown says that the remaining plans “failed to congruently ramp up member services support to process claims, respond to enrollment issues, answer provider questions, denials, authorizations, and payment.” Read the rest of this entry »
The Four Legs of a New Health-Care System
The new system should be fully consumer driven, empowering individuals to be the surveyors and purchasers of their care. Past reforms in this direction became stilted and ultimately incomplete, but the current moment offers a chance to truly rebuild from the ground up. If Messrs. Trump and Price want to make the most of this short window, they should keep four central reforms in mind.
1. Provide a path to catastrophic health insurance for all Americans. There’s ample evidence that enrollment in insurance doesn’t always lead to improvements in health—but access to health insurance is important nonetheless. A 2012 study from the National Bureau of Economic Research found higher insurance enrollment from reforms in Massachusetts led to better results in several measures of physical and mental health.
Health insurance is also important for financial security. The ObamaCare replacement should make it possible for all people to get health insurance that provides coverage for basic prevention, like vaccines, and expensive medical care that exceeds, perhaps, $5,000 for individuals.
Those Americans who don’t get health insurance through employers, or Medicare and Medicaid, should be eligible for a refundable tax credit that can be used to enroll in a health-insurance plan. The credit would be set at a level comparable to the tax benefits available to individuals with employer-sponsored insurance plans. The subsidy would be enough to make a basic level of catastrophic coverage easily affordable for all Americans.
2. Accommodate people with pre-existing health conditions. The price of insurance naturally reflects added risk. That’s why beach houses cost more to insure than a typical suburban home. Yet there is a reasonable social consensus that people should not be penalized financially for health problems that are largely outside of their control.
So as long as someone remains insured, he should be allowed to move from employer coverage to the individual market without facing exclusions or higher premiums based on his health status. If someone chooses voluntarily not to get coverage, state regulation could allow for an assessment of the risk when the person returns to the market. Read the rest of this entry »
Price has led efforts to craft a GOP alternative to the spectacularly unpopular Affordable Care Act.
WASHINGTON— Louise Radnofsky and Peter Nicholas report: President-elect Donald Trump has chosen House Budget Committee Chairman Tom Price (R., Ga.) as his nominee for secretary of the Health and Human Services Department, according to a transition team adviser, putting the six-term congressman in charge of the sprawling agency that will likely dismantle Democrats’ 2010 health-care overhaul.
“We think it’s important that Washington not be in charge of health care. The problem that I have with Obamacare is that its premise is that Washington knows best.”
Mr. Price, a 62-year-old former orthopedic surgeon, is one of several GOP physicians who sought to carve out a leading role in shaping the party’s health policy and, in particular, the party’s alternative vision to Democrats’ Affordable Care Act. Much of his criticism of the law has centered on the authority it gives to the federal government, and to the agency that he may now head.
“There’s a genuine desire to have us coalesce around a single plan so that the American people can see who’s trying to solve these challenges. I wouldn’t draw any lines in the sand other than that the path that we’re on doesn’t work.”
“We think it’s important that Washington not be in charge of health care,” he said in an interview this summer. “The problem that I have with Obamacare is that its premise is that Washington knows best.”
He has championed his own legislation, the Empowering Patients First Act, since 2009, taking a position on a number of hot-button issues for conservative health policy thinkers. In its latest iteration, the proposal includes refundable, age-adjusted tax credits for people to buy insurance if they don’t have access to coverage through an employer or government program. People in a government program, such as Medicare, Medicaid or Tricare, would also be allowed to opt out of it and get tax credits toward the cost of private coverage instead.
Mr. Price had previously included tax deductions in his plans, a tool typically favored by harder-line conservative health policy thinkers, but said he had “moved towards credits because we felt it was cleaner.”
The plan offers a one-time credit aimed at boosting health savings accounts, long described by supporters as a way of bringing down medical spending, and derives part of its funding from capping how much employers can spend on providing employee health care before being taxed. The plan seeks to make health insurance available to individuals with pre-existing medical conditions by helping states set up new “high-risk” pools or other programs for such enrollees, and sets new rules allowing insurers to sell policies across state lines.
But Mr. Price, whose rise in the congressional ranks began at the conservative Republican Study Committee and then steadily climbed, has already said he is open to compromise with fellow GOP lawmakers on many points. Read the rest of this entry »
Republicans have long been united, as a general principle, against the partial repeal of Obamacare. Their focus has wisely been on repealing, rather than fixing, President Obama’s signature legislation. Indeed, the very nature of Obamacare almost necessitates this approach. As Health and Human Services secretary Kathleen Sebelius explained about Obamacare even before the Democrats passed it without a single Republican vote, “[W]e have to have a comprehensive approach, because the pieces of the puzzle are too closely tied to one another.” She added, “Pieces of the puzzle are necessarily tied together if you have a comprehensive approach.” Comprehensive legislation, it follows, calls for comprehensive repeal. The last thing Republicans should be trying to do is incrementally improve Obamacare.