This may be the week that "Obamacare" became "The Affordable Care Act." With the news that the law will cover more people that expected, cost less than expected, and only get better from here, now seems as good a time as any for the GOP to starting walking back their 5-year-long attempt to associate the law with Obama.
Let's take a look at where we are.
Exchange enrollment has exceeded expectationsLet's take a look at where we are.
The magic number of the 7 million enrollment target (downgraded to 6 million after the website fiasco) hasn't just been met, it's been vastly exceeded.
Obamacare Tears Down Goalposts: 8 Million Sign-Ups
President Barack Obama announced Thursday that 8 million Americans had enrolled in private health coverage under Obamacare -- the final evidence that the law signed up far more Americans than most would have thought possible during the doldrums of last fall.
The uninsurance rate continues to fall.
Enrollment in private coverage through the exchanges (and potentially into private employer-sponsored coverage as well) and in public coverage through the Medicaid expansion has been reaching the uninsured.
Health insurance gains since last fall hit 12 million, survey shows
President Obama’s health law has led to an even greater increase in health coverage than previously estimated, according to new Gallup survey data, which suggest that about 12 million previously uninsured Americans have gained coverage since last fall.
Premiums and ACA costs are lower than anticipated.
All this is going to be cheaper than expected. The price tag of the law has fallen as premiums have come in below projections.
Lower premiums (yes, really) drive down Obamacare’s expected costs, CBO says
The health-care law's expansion of insurance coverage will cost $104 billion less than projected over the next decade, according to revised estimates from nonpartisan budget analysts Monday. Obamacare's lower-than-expected costs will come largely because premiums will be cheaper than previously thought.
The CBO and the Society of Actuaries anticipate only modest premium growth next year.
Despite a few scattered vague predictions of double digit premium increases this year, the general expectation is that premium increases will be historically low.
Smaller premium hikes forecast in 2015 for Obamacare
Insurance premiums under Obamacare are projected to rise less than 3 percent in 2015, a smaller-than-expected jump as the health insurance exchanges enter their second year.
The CBO and Joint Committee on Taxation released a series of new estimates Monday on the law’s costs and the number of people it will cover.
New data signal smaller jump in health care costs
"The double-rate increases we've been hearing are probably exaggerated," says Dave Axene, a fellow with the Society of Actuaries, adding that there would be wide variation across the country. "That's not what we're seeing from the actuarial organizations — I guess we're being a little bit more optimistic."
The exchanges are about to get more competitive.
This year was only the beginning! Insurers were feeling out what the new marketplaces would be like and the strong enrollment numbers are convincing some to expand their participation in the exchanges and others to enter them for the first time. This is going to be especially important for small markets; for instance, New Hampshire only had a single insurer (Anthem) selling in its exchange this year. By the next open enrollment at the end of this year, that number will have grown to three competing insurers.
Insurers see brighter Obamacare skies
Health insurers got their first taste of Obamacare this year. And they want seconds.
Insurers saw disaster in the fall when Obamacare’s rollout flopped and HealthCare.gov was a mess. But a strong March enrollment surge, along with indications that younger and healthier people had begun signing up, has changed their attitude. Around the country, insurers are considering expanding their stake in the Obamacare exchanges next year, bringing their business to more states and counties. Some health plans that skipped the new marketplaces altogether this year are ready to dive in next year.
Health care quality is improving.
The coverage expansions may be new this year but quality improvement isn't. The ACA has been working on that front for at least 2-3 years now and the results (while not news this week like the stories above are) are worth nothing.
National Committee for Quality Assurance -- State of Health Care Quality
This year [2012] we saw significant improvement in measures included in the Medicare Star rating pay-for-performance program for health plans that participate in Medicare Advantage. Although Medicare Advantage plans have reported on quality and results have been reported to consumers for many years, the Affordable Care Act required the Medicare program to make higher payments to health plans with better quality performance, starting in 2012. In addition to this new program, the Department of Health and Human Services established a demonstration program to complement it, making even higher payments to plans with better performance.
Obamacare Shows Hospital Savings as Patients Make Gains
Less than five months before the Affordable Care Act fully kicks in, hospitals are improving care and saving millions of dollars with one of the least touted but potentially most effective provisions of the law.
More hospitals improve quality of care
A larger number of hospitals are showing improvements in their quality of care said the Joint Commission in its annual report on quality and safety of hospitals.
All Pioneer ACOs improved quality; only third lowered costs
All 32 of the accountable care organizations in the program improved patient care and patient satisfaction against benchmarks, according to results shared with the Wall Street Journal in advance of their public release.
Is Obamacare working? Hospitals finally see drop in readmissions
New CMS figures show that the national rate of 30-day readmissions for Medicare patients dropped to 17.8% in November 2012 after spending years stuck at 19%—and White House officials say the Affordable Care Act deserves the credit.
The health care system is re-designing itself to start holding down costs and improving quality in the long-term.
The bigger question is whether health care reform is taking root to ensure that the system is on a sustainable footing going forward. And the evidence has been mounting that it is.
Do Structural Changes Drive the Recent Health Care Spending Slowdown? New Evidence
Value-based purchasing of hospital services has had a significant impact on hospital behavior. Hospitals are highly sensitive to changes in financial incentives. Movement away from a preponderance of fee-for-service payments is also likely to permanently alter hospital behavior. For instance, emphasis on reduced readmissions has reportedly changed how hospital managers think about care delivery, from the care delivered within their four walls towards coordinating care outside their four walls as they track patients as they return to the community or to various post acute care settings.
An observation is that hospitals and other providers are being called to change their care delivery models and business models as payment systems evolve. In a general sense this is leading to a re-engineering of care- slow to start with, but gaining momentum over time. The ACA, with its call for CMMI grants, shows the potential magnitude of private and public sector experiments with alternative organizational forms such as ACOs and medical homes in combination with payment system incentives in the form of payments for value, payment bundling and capitation and prompting the health care industry to reconsider delivery models that reduce incentives for volume of care under fee-for- service. As organizational forms and payment models evolve, augmentation of computing powers and more ready access to “big data” claims files emphasizes an ability to better understand the consequences of change in terms of clinical and economic outcomes.It's impossible to tell what effect any of this will have on the elections this year. While public opinion polling has generally shown that people don't want to scrap the law, it's also usually shown that they don't love it.
Unclear. But what does seem clear is that the ACA isn't going away anytime soon.
No comments:
Post a Comment