Obamacare continues to be a huuuuge success.

[rubato]

Let's see, 2.6 trillion $ how fast did Bush piss that away in the Iraq war?


https://www.washingtonpost.com/news/won ... -projects/

U.S. will spend $2.6 trillion less on health care than expected before Obamacare, study projects

A new study predicts that the federal forecast of national health care spending under President Obama's signature health law was a big overestimate — by $2.6 trillion over a five-year period.

Expanding health insurance coverage to millions of Americans was bound to increase overall spending. After the Affordable Care Act was passed in 2010, the actuaries for the Centers for Medicare and Medicaid Services projected that, as the economy recovered, the historically low growth in health spending would return to higher levels, reaching $4.6 trillion by 2019. But in the intervening years, the annual expenditure increases have been more modest than expected, and the new estimate from the Urban Institute suggests national health spending is on to track reach $4 trillion by 2019.

"When CMS originally made those projections, they really thought the slowdown in health-care spending [growth] was mostly due to the recession, and afterward we'd see a return to the higher rates of spending growth — and that didn't really happen," said Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation, which funded the new study by the Urban Institute.

Looking forward, the study's authors also point to recent evidence that a 2014 uptick in health spending that had seemed to signal a return to higher growth may have been temporary. If slower growth persists, they argue that it will become harder to argue that it is just the economy and not the cost containment policies enabled by the Affordable Care Act that are tempering spending. ... " see link for more

yrs,
rubato

[Bicycle Bill]

$2.6 trillion, divided by 320 million — the population, roughly, of the United States; every man, woman, and child alive today — equals $8,125 less being spent by the federal government on healthcare on (again) every man, woman, and child alive in the US today.

Why don't I quite believe that?

-"BB"-

[MajGenl.Meade]

health spending would return to higher levels, reaching $4.6 trillion by 2019. But in the intervening years, the annual expenditure increases have been more modest than expected, and the new estimate from the Urban Institute suggests national health spending is on to track reach $4 trillion by 2019

Oh goody! Spending by the year 2019 will be .6 trillion less than was forecast five years ago! Huzzah!

The odd thing is that the headline (2.6 trillion less) is absolutely not mentioned at all in the linked story. Did they accidentally drop 2 trillion on the floor under the desk?

[rubato]

health spending would return to higher levels, reaching $4.6 trillion by 2019. But in the intervening years, the annual expenditure increases have been more modest than expected, and the new estimate from the Urban Institute suggests national health spending is on to track reach $4 trillion by 2019

Oh goody! Spending by the year 2019 will be .6 trillion less than was forecast five years ago! Huzzah!

The odd thing is that the headline (2.6 trillion less) is absolutely not mentioned at all in the linked story. Did they accidentally drop 2 trillion on the floor under the desk?

From the linked story:

A new study predicts that the federal forecast of national health care spending under President Obama's signature health law was a big overestimate — by $2.6 trillion over a five-year period.

yrs,
rubato

[rubato]

$2.6 trillion, divided by 320 million — the population, roughly, of the United States; every man, woman, and child alive today — equals $8,125 less being spent by the federal government on healthcare on (again) every man, woman, and child alive in the US today.

Why don't I quite believe that?

-"BB"-

divided by 5 years that is $1,625 / yr. Pretty believable.

yrs,
rubato

[MajGenl.Meade]

From the linked story:

A new study predicts that the federal forecast of national health care spending under President Obama's signature health law was a big overestimate — by $2.6 trillion over a five-year period.

OF*S. You're just repeating the lead line which was in the OP.

Where does it explain this 2.6 trillion in the body of the article? All it mentions is that a 4.6 trillion estimate is now re-estimated to be 4.0 trillion

According to my math, that is 0.6 trillion (not 2.6 trillion less) than estimated. I hoped you'd explain rather than being yourself.

[oldr_n_wsr]

Insurer Aetna slashes ACA exchange participation to 4 states
August 16, 2016

Aetna has become the latest health insurer to retreat from the Affordable Care Act’s public exchanges by announcing a pullback that will further deplete customer choices in many pockets of the country.

The nation’s third largest insurer says it plans to leave nearly 70 percent of the counties in which it currently sells coverage as it trims exchange participation to four states in 2017, down from 15 this year. The insurer’s late Monday announcement comes after UnitedHealth and Humana detailed their own exchange pull backs for 2017 and after more than a dozen nonprofit insurance co-ops have shut down in the past couple years..they were losing billions of dollars anyway, and lost the startup billions too

Dwindling exchange participation from insurers is becoming a concern because competition is supposed to help control insurance price increases, and many carriers have already announced plans to seek price hikes of around 10 percent or more for 2017. Some states like Alaska and Oklahoma will be left with only one participant selling individual coverage in 2017..I guess those states are of no consequence in the bigger picture. Look on the bright side, they now have the holy grail, a single payer system

Urban markets or places with higher populations should still have plenty of health insurance choices on their exchanges for 2017, said Sabrina Corlette, a research professor with the Georgetown Health Policy Institute. But that may not be the case in many rural markets.screw those rednecks that live in the middle of nowhere, they're lucky there is a doctor in their neck of the woods

They can be less attractive to insurers because there are fewer customers over which an insurer can spread costs, and hospitals and other health care providers can build dominating market positions, making them formidable negotiating foes over rates.

Health insurers have been finalizing their exchange plans over the past several weeks, ahead of the Nov. 1 start of enrollment for 2017 coverage.

Corlette said it may still make take a few more years for insurer exchange participation to settle out, and the government may have to step in to tweak the market for insurers, “but I don’t think the market places are crashing and burning by any means.”.as long as there is one player the game can continue

Aetna had said earlier this month it was canceling expansion plans for its exchange business in 2017, and it promised a hard look at its current participation. The company covered about 838,000 people through the individual exchanges at the end of the second quarter.

The cuts mean it will sell coverage on exchanges in 242 counties next year, down from 778. The Hartford, Connecticut-based insurer will sell on exchanges in Delaware, Iowa, Nebraska and Virginia next year.

The exchanges have helped millions of people gain health coverage, most with help from income-based tax credits. But insurers say this relatively small slice of business has generated huge losses since they started paying claims in 2014. Insurers have struggled to enroll enough healthy people to balance the claims they pay from high-cost customers, and they have complained about steep shortfalls in support from government programs designed to help them.

The nation’s largest insurer, UnitedHealth Group Inc., had expanded rapidly into the public exchanges and sold coverage in 34 states this year. But it only plans to offer policies in three states next year, Nevada, Virginia and New York.
a net loss to 31 states

Aetna has said it has been swamped with higher than expected costs, particularly from pricey specialty drugs. The nation’s third-largest insurer said a second-quarter pre-tax loss of $200 million from its individual insurance coverage helped it decide to limit exposure to the exchanges.

Aetna hasn’t ruled out a future expansion on the exchanges “should there be meaningful exchange-related policy improvements,” .aka if a taxpayer bailout subsidy suddenly appears Chairman and CEO Mark Bertolini said in a statement.

Government officials say the exchanges are improving and healthier people are signing up, which helps insurers balance the claims they get from sicker customers. .if that were true, they wouldn't be cutting and running from much of their coverage areas

“Aetna’s decision to alter its Marketplace participation does not change the fundamental fact that the Health Insurance Marketplace will continue to bring quality coverage to millions of Americans next year and every year after that,” said Kevin Counihan, CEO of the federal exchange operator HealthCare.gov, in an emailed statement.

Some insurers are expanding on the exchanges.

Cigna Corp., which offers coverage in seven states, plans to add some new markets next year. Those include Chicago, Raleigh, North Carolina, and Northern Virginia..so one drops out of 31 STATES and another "expands" by 4 markets (Chicago, Raleigh, north Carolina and Northern Virginia are 'markets' not 'states'.

Molina HealthCare also is expanding its business, and Health Care Service Corp., which sells Blue Cross-Blue Shield coverage on exchanges in four states, will add New Mexico in 2017. .WOW, back up one state, guess they learned how to play the game during their covering of medicare/caid

Insurers like Molina that have reported success so far on the exchanges say they have focused on covering low-income customers in markets where they already have an established presence in Medicaid, the state-federal program that covers the poor.yes they did!!

But even Molina has scaled back its growth plans. The Long Beach, California, insurer sells coverage on exchanges in nine states and was considering adding two more for next year. But it decided instead to add counties in states where they already have a presence.

https://www.yahoo.com/news/insurer-aetn ... 43435.html

And all this while "forcing" people to have coverage. Could you imagine if people were not "forced" to have coverage?

ObamaCare should be swimming along, instead it has donned a life vest and is holding on to a life ring.

Even the taxpayer funded state exchanges are failing and some have closed up shop.

[rubato]

Let us review how capitalism works.

Aetna, a for profit company unlike Kaiser-Permanente, charges as much as possible for providing as little service as they can get away with. They don't like or are unable to compete effectively in a market where they are required to provide a certain level of service and prefer to operate only where they can charge more for lower service or even go back to rescissioning (writing policies, taking premiums and then cancelling on a technicality when there is a substantial claim) which is the highest profit of all. For-profit HC companies typically have a 20% overhead cost which they expect to pass on rather than reduce by improving efficiency.

Aetna and some other companies are hoping the game the system with the help of Republicans and break it so that more people may die uninsured, but their profits will grow.

http://acasignups.net/graphs

12.5 million more people with health insurance than under Bush. Huuuuge success.
16 million including Medicaid/CHIP enrollments.

Cost to hospitals for providing uninsured care cut by 30% Enormous success.

Rate of increase in HC costs reduced for several years. Huge success.


While a national health system would have been better, the ACA is the best possible at the moment.

If you want people to be poorer, sicker, and die younger work to defeat the ACA.

yrs,
rubato

[MajGenl.Meade]

From the linked story:

A new study predicts that the federal forecast of national health care spending under President Obama's signature health law was a big overestimate — by $2.6 trillion over a five-year period.

OF*S. You're just repeating the lead line which was in the OP.

Where does it explain this 2.6 trillion in the body of the article? All it mentions is that a 4.6 trillion estimate is now re-estimated to be 4.0 trillion

According to my math, that is 0.6 trillion (not 2.6 trillion less) than estimated. I hoped you'd explain rather than being yourself.

Still waiting.....

[rubato]

Instead of waiting you should try and read the linked article where all is made clear.


Or just be yourself.


yrs,
rubato

[MajGenl.Meade]

I read the entire article long ago and it doesn't explain anything of the kind.

A new study predicts that the federal forecast of national health care spending under President Obama's signature health law was a big overestimate — by $2.6 trillion over a five-year period.

Expanding health insurance coverage to millions of Americans was bound to increase overall spending. After the Affordable Care Act was passed in 2010, the actuaries for the Centers for Medicare and Medicaid Services projected that, as the economy recovered, the historically low growth in health spending would return to higher levels, reaching $4.6 trillion by 2019. But in the intervening years, the annual expenditure increases have been more modest than expected, and the new estimate from the Urban Institute suggests national health spending is on to track reach $4 trillion by 2019.

There. The headline says 2.6 trillion. The body of the article says the forecast was 4.6 trillion and the new prediction is 4.0 trillion.

Where in that article is there a new prediction that spending will be 4.6 trillion minus 2.6 trillion = only 2 trillion?

All I asked in the first place was for you to explain that. Instead of which, you apparently cannot explain it.

[Burning Petard]

The business model for insurance in general is in big trouble. A local but well known retail merchant used to end its tv commercials with the tagline "An informed consumer is our best customer."

Insurance companies operate on a basis of shared risk. Get a big pool and the total overall risk will be lower than the risk for many individuals. Scare the low risk individuals into believing they are higher risk to suck more of them into the pool. That lowers the insurance companies total pay out. Meantime, they park the cash flow into higher paying investments, which are drying up in this era of low interest rates.

But now, more and more people understand their own risk positions so generally healthy and younger individuals resist buying health insurance. It is harder and harder for almost any particular insurance company to cherry-pick their customers and get the low risk population into their pool. So United Healthcare, Aetna, Humana want out.

But over all, for me as a customer, just what does the private, for-profit, insurance company do for me? What service do they provide that is worth what they charge? Not what I pay, because they are collecting from many sources, including my former employer (health benefits to retirees), the government, and the actual health care providers.

That is last question is the one that argues for a single payer system.

snailgate

[Big RR]

Indeed, Burning. So long as the fine is lower than the cost of the premiums, one can assess the risk of a serious illness or injury and make a good financial case to forego the coverage--and if anything does arise, their losses can be capped at the maximum of a year after which they can join pool and get insurance which will cover their preexisting condition. This argues for universal coverage, not the system we have.

And the saber rattling of the insurers leaving some markets threatening to spread demonstrates why we should at least have a public option to counterbalance this and be able to tell the insurers to leave.

Finally, your question of cost benefit is exactly why a single payer system would be best--especially a system that was not hampered by law but could strike bargains with pharma companies and healthcare providers (and for all the bitching about medicare, few providers don't accept it).

[Long Run]

This argues for universal coverage, not the system we have.

Or, we go back to pre-ACA, but adopt the few provisions that actually make sense: keep the Medicaid expansion (except have a wealth test along with the income test); keep the adult child coverage; keep the elimination of annual and lifetime limits; keep mandatory renewal so people cannot be dropped; modify the incentives to individuals to obtain coverage; and then dump all of the heavy regulatory stuff like minimum essential health benefits, PCORI, reinsurance, employer and individual excise taxes, Forms 1094 and 1095, get rid of the Exchanges and go back to the state high risk pools (much simpler), and yes, bring back the pre-existing condition exclusion since this is why the ACA is so ridiculously complex and cumbersome (and there were already solutions for most of the people impacted by this). Let insurers do their business and let consumers decide what plan they want.

You can argue for a single-payer coverage system, but just know that in America we don't do certain government programs very well. This is why the least favorite medical coverages are Medicare, Medicaid and oftentimes the VA. In fact, the only reason many providers take patients covered by those programs is because they make it up on the private side. You take away the private insurance which subsidizes the government programs and combine that with our lousy governance, and we'll all be wishing for the good old days. Private insurance is far from perfect but most people are reasonably satisfied when they have it.

[Long Run]

The odd thing is that the headline (2.6 trillion less) is absolutely not mentioned at all in the linked story. Did they accidentally drop 2 trillion on the floor under the desk?

Thanks for catching that obvious error that has still not been corrected. I guess the poor papers have laid off most of their fact checkers and proof readers. The other day, there were at least three typos in headlines in our sports section.

And how is spending less than anticipated on healthcare considered a "win" for the ACA? As the article mentions, the main reasons spending has increased less than expected is because of affordability issues: the lingering effects of the bad economy and the high premiums and the high deductibles on so many plans. If the Affordable Care Act didn't make care more affordable, then it is pointless.

[Scooter]

There is no error for those who can read. The savings in the fifth year are about $600 billion. The cumulative savings over five years are $2.6 trillion. If one looks at the graph of the baseline vs. ACA forecasts, one can see how both numbers are arrived at.

Once again, the zeal to prove rubato wrong make his detractors look like illiterate morons.

[rubato]

And scooter wins!

Yes, it was very clear in the text and graphs provided.

And what surprises me is that none of them cared enough about the truth to try to understand it when it was not difficult; dislike of myself aside. Dislike of myself not aside, they are slaves to their emotions. Hatred of me, hatred of Obama, &c. makes them unable to think for themselves. They have hobbled their own minds and limp around contented in their bile. Cripples.




yrs,
rubato

[Long Run]

Thanks for that Scooter, we should have read that more carefully. I will still rate it a misleading headline, as is the headline of this thread. First, there is still a lot more being spent under the ACA. B, the way to make the "savings" appear bigger is to provide a cumulative total rather than an annual amount or a percentage. III, the smaller than expected increases are not a positive development since it means people are using less healthcare. What would be a success is if more people have coverage at a lower cost . There is no evidence in the story that care is more affordable, instead, the story points to how unaffordable care is as the main reason that overall spending is not as high as expected.

[rubato]

Speaking of hating Obama; how much do you have to hate your own citizens, depriving millions of them of health care and costing your own state billions of dollars just to spite him?

http://www.rwjf.org/en/library/research ... icaid.html

The Cost to States of Not Expanding Medicaid

August 8, 2016 Publisher: Urban Institute Publication: Quick Strike Series
Author(s): Dorn S, and Buettgens M

A man completes enrollment forms at a health care event.

If the nineteen nonexpansion states expanded Medicaid, they would see economic savings.



The Issue

States that have expanded Medicaid report net budget savings, furthering the claim that nonexpansion states are losing out on potential economic savings.
Key Findings

From 2017 through 2026:

For every $1 a state spends on Medicaid expansion, it draws in $7 to $8 from the federal government.

By expanding Medicaid, the 19 states that have yet to expand Medicaid would see an estimated $27 billion drop in uncompensated care spending.

If the 19 holdout states expanded Medicaid, the federal government would spend $43 billion less on uncompensated care and $129 billion less on marketplace subsides.

Conclusion

For most states with relevant analyses, net budget gains are expected for the foreseeable future, even after states begin paying 10 percent of expansion costs.

link to full report:

http://www.rwjf.org/content/dam/farm/re ... rwjf430767

Its the whole Republican party who are made stupid by hatred.


yrs,
rubato

[oldr_n_wsr]

Money for medicare comes from the state or from feds. Either way it all comes from us.