Here’s how Pennsylvania’s Medicaid expansion plan works

by Rob Cullen on September 15, 2014 - 6:58 PM

corbett healthy pa announcement

Almost exactly one year ago, Pennsylvania’s Republican governor Tom Corbett announced that rather than implement Obamacare’s Medicaid coverage to anyone making less than 138% of the poverty line, he was putting forth his own plan. Named “Healthy Pennsylvania,” it would slash benefit to new and existing Medicaid recipients, charge premiums, institute a work requirement, and put new enrollees into private plans.

All of this needed federal approval, and after a long negotiation with the White House and Corbett have reached an agreement. The final version contains some elements of Corbett’s plan, but it looks much more like the state’s existing Medicaid system. If you’re a Pennsylvania resident, here’s what you should know about it.   [click to continue reading...]

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More good news about Obamacare premiums for next year

by Rob Cullen on September 10, 2014 - 1:29 PM

A few weeks ago, we pointed out that there are a few different ways to calculate how much Obamacare premiums are changing next year. For example, you could simply look at the price of the average plan in an area from last year to this year. Or you could take it a step further and do a weighted average; that’s where plans with more enrollees count more heavily, so you get a better sense of how much premiums will change for the average policyholder.

That information is useful, but remember that the idea behind Obamacare is not that your premiums will never change; it’s that you’ll be able to shop around for the best deal without worrying about your health status. Last year most people picked one of the cheapest silver options in their area, so it would be really helpful to compare those prices to the cheapest options now.

That info wasn’t available when we wrote the post, but we have it now, thanks to a new study from the Kaiser Family Foundation– and the results are good news for anyone shopping for Obamacare coverage next year.   [click to continue reading...]

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Fixing Obamacare, Part 1: The employer mandate

by Rob Cullen on September 3, 2014 - 4:03 PM

obama ceo's

Among psychologists, the term “catastrophizing” is used to describe a thought pattern where someone views an event or situation as worse than it actually is. There are two parts: (1) predicting a negative outcome, and (2) jumping to the conclusion that the negative outcome would be the end of the world.

“Catastrophizing” is the perfect way to describe how the Republicans have approached Obamacare over the past few years. There was seemingly no end to the predicted disasters: young, healthy people wouldn’t sign up, it would explode the federal deficit, insurance costs would skyrocket, it would lead to Medicare “rationing,”… the list goes on.

Of course, none of these predictions have come true– it’s become clear that Obamacare is working (and working particularly well in states that have embraced it). Meanwhile, Republicans have gotten quieter about it. As Bloomberg News reports, Obamacare is losing its punch as a campaign weapon: since April, the number of anti-Obamacare ads has dropped dramatically, while a Democratic senator in a tight race in Arkansas has begun touting its success.

That’s not to say that the law is working perfectly though. Now that there’s less nonsense floating around about how Obamacare is destroying America, we figured it might be a good time to look at some actual problems with the new law, and what Congress could do to fix them.

First up: a provision that Republicans and Democrats agree should probably be scrapped, yet Republicans are suing the president for not implementing it. Welcome to the employer mandate.   [click to continue reading...]

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Has Congress done anything to screw over ALS patients recently?

by Rob Cullen on August 26, 2014 - 3:10 PM

Paul Ryan Mitt Romney ice bucket

Mitt Romney does the Ice Bucket Challenge with some help from Paul Ryan. We should point out that their proposed budget would have meant huge cuts to health research.

Glad you asked. In 2010, the National Institutes of Health (NIH) devoted $59 million towards ALS research– by 2013, that figure had dropped to $39 million. So what happened?

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Got questions about the ALS Ice Bucket Challenge? This might help.

by Rob Cullen on August 26, 2014 - 8:49 AM

ice bucket challenge kids

If you’re reading this you have access to the internet, which means by now you’ve seen (or at least heard about) videos of people dumping buckets of ice water on their heads to raise money and awareness about ALS. However, the videos tend to be short and don’t have much context, so if you’re curious for more information about ALS, how the challenge started, how well it’s working, and other issues that have been raised, read on.   [click to continue reading...]

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What you should know about insurers’ proposed rates for next year

by Rob Cullen on August 12, 2014 - 8:08 AM

aca help desk

A reader in Louisiana writes us:

This was in the local paper.

Basically Blue Cross is saying that claims are up this year so they want to increase premiums on ACA policies. Have you been seeing this in other states? Is this increase in claims really unexpected?

Your insight appreciated as always!

They’re both good questions, and as insurers release their planned rates for 2015, we’re starting to get a sense of how Obamacare premiums will be changing across the country. Here’s what you should know.   [click to continue reading...]

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jonathan gruber

In our last post, explaining the most recent Obamacare court battles, we pointed out that there was no evidence that Congress intended to withhold subsidies on the federal exchanges. Well, on Friday conservatives said they’d found proof– a January 2012 speech from Jonathan Gruber, an MIT health economics professor and former adviser to the White House, where he gave this response to a question from an audience member:

I think what’s important to remember politically about this, is if you’re a state and you don’t set up an Exchange, that means your citizens don’t get their tax credits. 

And later in the afternoon, video surfaced from the Q&A of another speaking engagement where he said basically the same thing.

These two comments have received a ton of attention– not because they prove anything about Congress’s intent regarding the subsidies (after all Gruber was just one of many, many advisers helping with the law). Instead they’re subject of intense focus because they’re literally the only evidence that opponents have to make their case. Yet these statements are contradicted by the facts at the time, Gruber’s own work on the bill, and the hundreds of other people involved in writing and reporting on Obamacare over the last few years.   [click to continue reading...]

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What this week’s court rulings actually mean for Obamacare

by Rob Cullen on July 24, 2014 - 8:55 AM

Conservatives once said that Obamacare was a complicated monstrosity-- now they're arguing that its language was perfectly clear.

Conservatives once said that Obamacare was too complicated to understand– now they’re arguing that its language was perfectly clear.

We’ve been hesitant to write much about the latest Obamacare lawsuits working their way through the courts– mostly because they seemed unlikely to go anywhere. The issue in these cases is whether certain Obamacare exchanges are allowed to provide the subsidies that make premiums affordable for most people. Unlike the big Supreme Court decision a couple years ago, these lawsuits don’t involve whether or not the law is constitutional; instead it has to do with interpreting what Congress meant in a section of the law that’s somewhat unclear, and the case that Congress intended not to provide the subsidies is very, very slim.

Yet… here we are. Yesterday the D.C. Circuit Court of Appeals, in Halbig v. Burwell, ruled that Congress did in fact only mean for subsidies to go to certain exchanges. Then, just two hours later, the 4th Circuit Court ruled the exact opposite, saying the same thing as other lower courts: subsidies should be available in all 50 states.

So what happens now? Probably still not much– the D.C. Court decision will almost certainly be overruled soon– but since it now looks like there’s a slight chance the case could make it before the Supreme Court, here’s an explainer on what’s at stake.   [click to continue reading...]

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The two strangest parts of the Hobby Lobby decision

by Rob Cullen on July 17, 2014 - 9:42 AM

Reading the Supreme Court’s decision in the Hobby Lobby case, you can tell that the majority justices see it as a win-win: religious employers don’t have to pay for something that conflicts with their religious beliefs, while their female employees can still get contraceptive coverage. All the government has to do is extend the accommodation it already made for religious nonprofits (basically they fill out a form, a third party administrator provides the coverage, and the government will pick up the tab) to these for-profits as well. Or as Slate’s Emily Bazelon summed up their thinking: “No sincere belief harm, no IUD foul.”

So why then, does it seem to so many people like a particularly bad decision?   [click to continue reading...]

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Explainer on the Supreme Court’s contraceptive decision

by Rob Cullen on July 3, 2014 - 2:08 PM

In what’s becoming an annual June tradition, the Supreme Court issued another landmark healthcare ruling this week. In a 5 to 4 decision, the Court ruled that certain corporations don’t have to cover birth control in the insurance plans they provide their employees. The decision doesn’t eliminate Obamacare’s “contraception mandate,” but it does narrow it, and millions of women could be affected.

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