Tuesday, July 22, 2014

Good news about Obamacare


The New England Journal of Medicine reports that an awful lot of us are benefitting from Obamacare:

"Taking all existing coverage expansions together, we estimate that 20 million Americans have gained coverage as of May 1 under the ACA," the authors wrote. "We do not know yet exactly how many of these people were previously uninsured, but it seems certain that many were."

They reached the 20 million total this way: 1 million adults under age 26 enrolled in their parents' plan; 8 million enrolled in private coverage through the insurance marketplaces; 5 million enrolled in private coverage directly through their insurer; 6 million enrolled in Medicaid.

That's one hell of a lot of people whose security is somewhat greater because, if they get sick, they have some chance of getting appropriate medical care without going bankrupt. Not too shabby.

Meanwhile, hospitals are hurting in states that have taken the Supreme Court's invitation to evade covering many of their poor people when the judges made expansion of Medicaid voluntary, according to Forbes.

The moves against expansion are “beginning to hurt hospitals in states that opted out,” a report last week from Fitch Ratings said. The U.S. Department of Health and Human services has said Medicaid enrollment in the 26 states and the District of Columbia that agreed to go along with and implemented the expansion by the end of May “rose by 17 percent, while states that have not expanded reported only a 3 percent increase,” HHS said in an enrollment update for the Medicaid program.

“We expect providers in states that have chosen not to participate in expanded Medicaid eligibility to face increasing financial challenges in 2014 and beyond,” Fitch said in its July 16 report...

Uh oh -- will the medical establishment push Republican governors and legislators to get on with insuring their people? Time will tell.

The Supreme Court's Hobby Lobby decision allows some employers to refuse to cover their insured employees for some or all birth control methods. The U.S. Department of Health and Human Services has ordered that companies that want to limit their workers' coverage must inform the workers.

Employers that intend to drop coverage for some or all forms of contraception in the wake of the Supreme Court's Hobby Lobby decision must notify employees of the change, the Obama administration said Thursday.

The notice was posted on the Department of Labor website as a new "frequently asked question" about the Affordable Care Act, the health care law passed in 2010 and still being implemented.

That's only sensible: you don't want employees thinking a medical necessity they expect to have covered is excluded. But also, if a corporation wants to argue it has a religious exemption that enables it to avoid giving people the full coverage their neighbors get, it should at least have to tell the affected workers that their insurance has been limited in accord with the boss' opinions.

UPDATE: You might know that the day I would point this news out, a federal court would use highly tendentious "reasoning" about Congressional intent to try to kick the underpinnings (the subsidies) from under the system and collapse Obamacare. This isn't over -- there are many months of appeals ahead. We'll get to see whether the judicial branch is really willing to take the opportunity to access medical care away from what is estimated to be 4.5 million people.

Here's a map that shows how much premiums would rise if the courts decide to play this game of kick the poor people.

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