Saturday, December 5, 2015

ObamaCare Salvage Operation

To Sylvia Mathews Burwell, Secretary of Health and Human Services, has fallen the unenviable task of salvaging ObamaCare over the next 13 months until the 2016 elections until President Obama finishes his 8 years as President.

At age 50, she is well equipped for the job, as Harvard graduate and Rhodes Scholar. She has served at HHS secretary since June 2014, and before that ran the Bill and Melinda Gates Foundation and WalMart Foundation. She spent 8 years in the Clinton administration in various health positions and more recently led the Office of Management and Budget. She has brains and political savvy.

It will be a formidable salvation operation, which can be defined as the recover, evacuation, and reclamation of damaged, discarded, condemned, or abandoned material for reuse, repair, refabrication, or scrapping.

ObamaCare is not ready for the scrap heap yet, but it is getting there. The Senate has just voted to repeal key provisions of the Patient Protection and Affordable Care Act, such as the individual and employer mandates, Medicaid expansion, and, to add political insult to political injury, to defund Planned Parenthood.

The Republican House will back the Republican Senate, and President Obama will veto repeal. There is no guarantee the GOP will win the Presidency or retain the House. But the stage has been set for repeal should they accomplish both goals.

According to a December 4 Bloomberg article, “The Woman Who Has 13 Months to Bolster ObamaCare, “ the stakes could not be higher for Ms. Burwell.

HHS is about to launch its third healthcare. Gov signup, and there are signs it will fall far short of its goal of signing up 10 million more for health exchanges.

Premiums are going up 10% of more in many markets, sometimes even up to 50%, and the healthy millenials, many of whom are unemployed and living in their parents’ basements, are disinclined to sign on even in the face of $695 penalties for not doing so.

People are having a tough time understanding how to shop for care, and the shopping website still have glitches.
To make matter worse, 12 of 23 state non-profit co-ops have failed, and UnitedHealthcare has announced it may withdraw from because of heavy losses from sicker than expected enrollees.

Burwell points out that 17.6 million people gained coverage under the law. which includes the expansion Medicaid coverage to low-income people, and young adults who are allowed to stay on their parents’ policies longer than before the ACA. The uninsured rate has fallen to about 11.6 percent, from 17.1 percent just before the law went into effect.

Critics call a provision of the law requiring companies with more than 50 fulltime workers companies as a job killer. And doctors and hospitals are resisting federal efforts compelling them to join Accountable Care Organizations, which have yet to prove they save Medicare money.

Government actuaries estimate that health-care spending in the U.S. will rise by about 5.8 percent annually through 2024, a sharp spike from the 2.9 % rate in 2013, and federal spending on health care now tops $3 trillion, or 17.6 % of GDP
“I’m deeply focused on what I’m working on now, and enjoying it, and it’s challenging every day,” Burwell says, “I think we will see what happens in terms of all of those issues, and I look forward” after the Obama administration ends, “to observing and watching what happens.”

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