Obamacare... Desastre o Panacea?????

Cierto es que pronto veremos en carne propia los efectos y costos de la medicina socializada del Obama-care... Esperemos que leden machete a tiempo.

We're About to Learn Who Was Right about Obamacare
By Conor Friedersdorf

The legislation's survival shouldn't turn on Election 2012 -- how it performs in the next four years should be decisive.


The passage of President Obama's health care bill and the Supreme Court's stamp of approval caused many conservatives to treat Election 2012 as their last chance to stop the legislation. Democrats celebrated their victory at the ballot box in part because the entirety of the Affordable Care Act will now go into effect. In both parties, the prevailing assumption is that the law is here to stay -- that once an entitlement takes effect, what Republicans call the welfare state and Democrats call the social safety net has been ratcheted one more click leftward, irreversibly.

Does Rep. Paul Ryan disagree? Speaking to the National Review Institute over the weekend, he suggested that the Republican Party's opposition to Obamacare is just beginning. "In the president's first term, we argued against big government in theory," he said. "In his second, we will argue against it in practice. Obamacare is no longer just a 2,000-page bill. Now, it's 13,000 pages of regulations. And it's growing. This year, the law will restrict our ability to use flexible-spending accounts. It will even raise taxes on life-saving medical devices. And that's just health care."

As a Republican politician, Ryan has an incentive to overstate the costs of Obamacare, but he's right that it's changing from something exhaustively debated in theory to a policy with real world successes and failures. If they occur in anything like the ratio Rep. Ryan suggests, running on the repeal of Obamacare ought to be easier four years from now than it was during Election 2012.

On the other hand, the Republicans fought the passage and implementation of Obamacare by running against death panels, socialism, Medicare cuts, and the United States becoming another Europe. So even if the legislation goes very wrong in exactly the ways that wonkier critics like Reason's Peter Suderman predicted, GOP politicians won't exactly be able to say "I told you so." If Obama winds up making the health care system somewhat worse, even as "death panels" never materialize, market capitalism survives, Medicare endures, and it still doesn't feel like Europe, many rank-and-file conservatives will be relieved, or even pleasantly surprised.

Hopefully the GOP's rhetorical excesses, ineptitude, and dearth of coherent policy alternatives on health care won't prevent America from having an honest reckoning with how Obamacare unfolds. It's certainly worth comparing its performance to the confident claims made by left-leaning wonks about all the necessary cost cutting it'll do, among other theoretical features. I expect the unintended consequences to be significant and the cost-cutting illusory. But I could be wrong.

Time will tell.

Unfortunately, the political class is turning its attention away from the health care law just as it's coming into effect. So it goes when so many people care so much more about politics than governing. I count Paul Ryan among those people, but kudos to him for noting that empirical results are on the way. They ought to be the decisive factor in whether or not Obamacare survives.

Tremenda noticia para los que compran su seguro medico independientemente... Van a pagar caro para que el pobre tenga seguro medico... Sigan votando por Obama...



<LI class=dateStamp>Updated March 22, 2013, 8:04 a.m. ET</LI>


Health Insurers Warn on Premiums





<H3 class=byline>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.

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.




UnitedHealth Group, the nation's largest carrier, and other health insurers said premiums for some individuals and small businesses could rise.

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 +0.67%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 -0.31%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.
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Imaginense si el Obamacare es un desastre... Van a tener que postponer la implementacion porque a nadie le gusta el modrio legislativo porque no hay quien lo quiera...


White House delays health-care rule that businesses provide insurance to workers
By Zachary A. Goldfarb and Sandhya Somashekhar, Published: July 2
The White House on Tuesday delayed for one year a requirement under the Affordable Care Act that businesses provide health insurance to employees, a fresh setback for President Obama’s landmark health-care overhaul as it enters a critical phase.

The provision, commonly known as the employer mandate, calls for businesses with 50 or more workers to provide affordable quality insurance to workers or pay a $2,000 fine per employee. Business groups had objected to the provision, which now will take effect in January 2015.

The decision comes as Obama is working to secure his domestic legacy, urging Congress to pass an overhaul of immigration laws and using his executive powers to combat climate change. With the prospects for immigration reform uncertain in the House — and new environmental regulations still more than a year way — implementation of the 2010 health-care law has singular importance.

The White House portrayed the delay as a common-sense step that would reduce financial and regulatory burdens on small businesses. Republicans, who are planning to target “Obamacare” in the 2014 midterm campaigns, said the delay is an acknowledgment that the health-care overhaul is flawed.

The decision will spare Obama what might have been a major distraction as officials begin to implement the centerpiece of the health-care law, which remains in place: a requirement, starting in 2014, that most Americans obtain insurance through their employer or through federally backed and state-backed marketplaces, known as exchanges.

The decision by Obama, who was on Air Force One returning from Africa on Tuesday when the announcement was made, to delay a controversial part of the law underscores his willingness to use the power of the executive branch to help to protect the legislation’s image at a defining moment.

“We believe we need to give employers more time to comply with the new rules,” Valerie Jarrett, a senior adviser to Obama, wrote in a blog post Tuesday evening. “This allows employers the time to . . . make any necessary adaptations to their health benefits while staying the course toward making health coverage more affordable and accessible for their workers.”

Republicans say they expect higher costs as a result of the law. House Speaker John A. Boehner (Ohio) said the decision “means even the Obama administration knows the ‘train wreck’ will only get worse.” He added, “This is a clear acknowledgment that the law is unworkable.”

Bob Kocher, a former top health-care aide to Obama, said he was disappointed by the delay because it will create uncertainty about what parts of the law will take effect. “It confuses people,” he said, adding that it “will undermine all the other rules because people will expect delay.”

The health-care law, which had been a source of confusion for years, is expected to have a bumpy rollout. The employer mandate would have added complexity.

Small businesses, many of which would have had to install systems to track and report which employees are receiving coverage, had been complaining about the difficulty of complying with the requirements, giving way to fears that companies might reduce their workforces to fall below the 50-worker threshold.

The decision comes as a result of years of bumps and setbacks for the overhaul, including legal challenges and political opposition that have hampered its implementation. Last summer, the Supreme Court upheld the law but struck down a mandatory expansion of Medicaid. State officials and businesses held off changing their policies through the 2012 presidential campaign because Obama’s GOP opponent, Mitt Romney, had promised to repeal the law.

Some populous states, including Florida and Texas, have decided not to set up exchanges, putting a far bigger burden on federal health officials to serve Americans. The exchanges are being designed to offer a variety of insurance plans; the federal insurance exchange is set to begin in less than three months.

Although the overhaul was passed in 2010, federal officials continue to issue clarifications to its language. Many of the rules critical to employers were issued this year, or remain in draft form. As a result, businesses have been scrambling to understand their obligations, said Larry Levitt, senior vice president of the Kaiser Family Foundation, a nonpartisan health think tank.

“When I talk to large companies, even though they already offer coverage they are still scrambling to understand the rules so they can comply,” he said. “Employers were feeling like they had to make these decisions under some amount of pressure, and this gives them a year to be more deliberative about it.”

A senior White House official said the administration’s decision goes beyond delaying the employer mandate. Officials also are working to simplify the depth of information that businesses will have to provide to the government about the coverage they offer.

The launch of the exchanges is a landmark moment in the overhaul, and White House officials have been warning that there will be rough spots. The White House hasn’t received the funding it requested to implement the law, and officials have expressed concern that Americans eligible for coverage won’t know how to get it.

Earlier this year, the administration said businesses that buy health plans for their workers through health exchanges would not have access to the full range of options in 2014, promising to have them in place a year later.

The decision to postpone the employer mandate is not expected to have a major impact on employees. Those workers who would have received coverage from their employers as a result of the law will now be expected to use the exchanges. Employees who cannot afford coverage on their own are eligible for federal subsidies.

The vast majority of businesses — 96 percent, according to the White House — have fewer than 50 employees and therefore are exempt from the mandate. And nearly all firms of 200 or more workers offer their employees some sort of coverage, according to the Kaiser Family Foundation.

“We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively,” Mark J. Mazur, an assistant Treasury secretary, wrote in a blog post. “We recognize that the vast majority of businesses that will need to do this reporting already provide health insurance to their workers, and we want to make sure it is easy for others to do so.”

Mazur wrote that Treasury, which oversees part of the law, will issue more details about the delay within a week.

Several business groups praised the administration, saying the delay will give businesses time to adjust to the new requirements.

“This one year delay will provide employers and businesses more time to update their health care coverage without threat of arbitrary punishment,” Neil Trautwein, a top official with the National Retail Federation, said in a statement. “We appreciate the Administration’s recognition of employer concerns and hope it will allow for greater flexibility in the future.”

But others maintained that the provision will never be workable.

“Temporary relief is small consolation,” said Amanda Austin, director of federal public policy with the National Federation of Independent Business, which last year lost the landmark Supreme Court case challenging the law’s constitutionality.