Wednesday, January 27, 2016

On Armstrong and Getty Show for Obamacare Update, Discussion of Latest CBO Report Covering Enrollment & Unaffordable Deductibles

I was on the air with Jack Armstrong and Joe Getty this morning to discuss the CBO's latest Obamacare numbers and its enrollment prognostication.

You can also hear this audio on one of Armstrong and Getty's podcast pages, here.

CBO Report: Obamacare Will Enroll 40% Fewer Than It Predicted Last Year - Audio from my visit on the Armstrong and Getty Radio Program.
  • PPACA to cover 40% fewer than CBO projected 10 months ago
  • More employees pushed into Medicaid where health outcomes don't improve; not PPACA Exchanges
  • CBO: The ACA reduces people's incentive to work, thereby further diminishing the U.S. labor participation rate
  • Deductibles so high for many on PPACA Exchange plans, they cannot afford care

Tuesday, January 26, 2016

On Michael Berry Show for Obamacare Update and Discussion of Latest CBO Report Covering Exchange Enrollment & Suppressed Employment

I spent most of the 3 PM hour with Michael Berry providing an Obamacare update and discussing much of the below article.

-The audio may take a moment to load-

You can also hear the audio on Michael's site here (skip to 15:20).

Stunning CBO Report: Obamacare Will Enroll 40% Fewer Than It Predicted Last Year - Audio from my visit on the Michael Berry Radio Show.
  • PPACA to cover 40% fewer than CBO projected 10 months ago
  • More employees pushed into Medicaid where health outcomes don't improve; not PPACA Exchanges
  • CBO: The ACA reduces people's incentive to work, thereby further diminishing the U.S. labor participation rate

Shocking CBO Report: Obamacare Will Enroll 40% Fewer Than It Predicted Last Year

In summary
  • PPACA to cover 40% fewer than CBO projected 10 months ago
  • More employees pushed into Medicaid where health outcomes don't improve; not PPACA Exchanges
  • CBO: The ACA reduces people's incentive to work, thereby further diminishing the U.S. labor participation rate

Federal bureaucrats issued yet another Congressional Budget Office (CBO) report yesterday, and buried deep inside was the revelation that the best, least partisan experts available were off by nearly half in their evaluation of PPACA's ability to cover the uninsured.  That's right, Obamacare's efficacy in covering the uninsured is 40% weaker than government experts projected just 10 months ago.  That is a stunning decline.

Under this updated projection, ObamaCare will enroll about 13 million customers this year: a reduction of 40% from last year’s enrollment prediction of about 20 million. Unfortunately, the reduced number of enrollees does not translate into a decreased price tag for the PPACA behemoth. In fact, the opposite appears true.

PPACA Covers Fewer While Costing More Per Person

The CBO further projects that the number of people receiving taxpayer handouts to buy Obamacare plans will be higher than expected.  Roughly 11 million people are expected to receive subsidies this year, compared to about 8 million people last year.  In addition, the CBO projects that per-person spending on healthcare programs “will grow more rapidly than it has in recent years.”  Taxpayers are expected to pay $18 billion more for Obamacare premium handouts in in 2016, reaching a total of $56 billion, and doubling that within the next ten years.

Less in Partially Private Funded Obamacare Plans, More On Purely Socialized Plans

As you may recall from prior posts, Medicaid is so woefully inadequate as a mechanism for insurance that it has "no significant effect" on health outcomes versus being uninsured. Much of this is because, in many cases, Medicaid's reimbursement rates do not even cover a provider's cost of issuing treatment. This graph from Forbes helps to illustrate the point.

For this woeful "benefit" taxpayers pay about $6,000 per beneficiary per year.

In 2014 and 2015 Medicaid spending grew by $36 and $48 billion respectively.  That is a 30% increase in just two years under PPACA. As you may recall (from page 73 of the downloadable CBO report):
Beginning in January 2014, the Affordable Care Act (ACA) gave states the option of expanding eligibility for their Medicaid programs to people with income at or below 138 percent of the federal poverty guidelines. By the end of 2015, 30 states and the District of Columbia had expanded their programs. The federal government pays a greater share of the costs incurred by enrollees who were made eligible for Medicaid in those states than it does for traditional enrollees: The federal share for those newly eligible enrollees is 100 percent through 2016 and declines thereafter, falling to 90 percent in 2020. In 2015, the federal government’s overall share of Medicaid expenditures was about 63 percent. 
The CBO goes on to forecast Medicaid spending to increase by 9% from 2015 to 2016, but only expects one million additional monthly beneficiaries.  This means that the CBO must increase its 2025 projection for Medicaid enrollment under Obamacare expansions from 11.5 to 14.5 million and increases taxpayer outlays for Medicaid from $97 to $114 billion by 2025.

Less People Participating in the Labor Market Due to PPACA

The CBO report continues to prognosticate that Obamacare will result in reduced labor force participation, specifically because it increases the marginal tax rate on work and provides additional rewards (governmental premium support subsidies) to those who don't work or are under employed (generally less than 30 hours per week).

One of the most astonishing statements in the report appears on page 35 of the downloadable PDF, where it states:
The most sizable effects [on the supply of labor] stem from provisions of the Affordable Care Act (ACA). The ACA’s largest effect on the labor market—especially as overall employment conditions improve—will come from provisions of the act that raise effective marginal tax rates on earnings, thereby reducing how much some people choose to work.
I suspect you will not see that language quoted anyplace in the mainstream media. That same paragraph goes on to explain:
The health insurance subsidies that the act provides through the expansion of Medicaid and the exchanges are phased out for people with higher income, creating an implicit tax on some people’s additional earnings. The act also directly imposes higher taxes on some people’s labor income. Because both effects on labor supply will grow over the next few years, CBO projects, they will subtract from economic growth over that period.
Put simply, PPACA penalizes additional work and that penalization will continue to grow over time, thereby more heavily burdening the U.S. economy.  Just in case the CBO did not make that point clearly enough, it was reiterated again on page 52 of the downloadable PDF:
The ... projected fall in potential labor force participation stems from some people’s reduced incentive to work as a result of the ACA and the structure of the tax code (whereby rising income pushes some people into higher tax brackets). Both effects reduce workers’ incentive to supply labor.
Source: The CBO Budget and Economic Outlook: 2016 to 2026
Nothing will change until after our Presidential election.  That new President will need to act fast and work with congress to address this nightmare.  Healthcare costs are escalating far too rapidly while we still have far too many uninsured and underinsured. PPACA needs dramatic reconstruction or replacement to not only address the problems - but to stop making them worse.

After publishing this article this morning, I went on the Michael Berry Radio Show to discuss it and some other PPACA updates with Michael.  You can listen to that here: 
- Audio may take a moment to load -

You can also hear the audio on Michael's site here (skip to 15:20).   

The following morning, I was on Armstrong and Getty discussing this story.  That Audio is here:

Or here on one of the Armstrong and Getty Podcast pages.

Sunday, January 24, 2016

How That "Free" Wellness Visit Can Cost You Twice

My client HR departments regularly receive employee inquiries based on this flaw in PPACA. I always explain during open enrollment meetings that your "free preventive" visit to the doctor is never free.  Instead, it is prepaid in your premium.  Once the government mandated a "free" preventive visit, carriers responded by increasing premium by about half a percent to account for the added cost.  And once again, in the never ending game of Whack-A-Mole, employers and employees take the blow.

Beyond that, your visit is rarely sans copay.  Yes, if you are in excellent health and have a purely preventive checkup in which your physician does not  follow up on any ongoing care issues (such as cholesterol, diabetes, blood pressure, weight management, etc.) you might get out of the doctor's office without a copay.  But for the other 80 percent of us, our premiums went up half a percent and we're paying the copay or the added cost of care under a fee for service plan.

Thank you sir, may I have another?

From Devon Herrick at NCPA:
Preventive care is supposedly free under Obamacare. However, a recent article in U.S. News & World Report discussed the confusion that often occurs when people see their doctor for their annual “free” wellness visit. The problem: it is easy to inadvertently cross the line into non-free medical services that cause the wellness visit to be coded as something rather costly. 
Patricia Jones thought she was getting the much-talked-about free physical under Obamacare when she went to see a doctor in May. But, she says, a few small things that happened during her checkup ended up making the visit cost more than $450. 
Indeed, asking the wrong question during a wellness visit can sometimes result in the physician using a different billing code other than the “free” codes for preventive medical services. 
In the process of answering questions from her doctor, Ms. Jones and her doctor turned a wellness visit into a diagnostic visit. Diagnostic visits are not covered under preventive care. Moreover, many people have high-deductible plans. A question or two, or agreeing to tests that are not medically necessary, can easily make that free wellness visit into a diagnostic visit that must be entirely paid for out of pocket. 
Stop for a minute and think about the implications. A wellness visit that does little more than take your blood pressure and ask how you’re feeling is essentially worthless if your doctor is not allowed to act on anything he or she finds. 

Saturday, January 23, 2016

Under Obamacare, Medi-Cal Ballooned to Cover 1 in 3 Californians

From the Los Angeles Times:
California officials never anticipated how many people would sign up for state-run health insurance under Obamacare. 
The state’s health plan for the poor, known as Medi-Cal, now covers 12.7 million people, 1 of every 3 Californians. 
If Medi-Cal were a state of its own, it would be the nation’s seventh-biggest by population; its $91-billion budget would be the country’s fourth-largest, trailing only those of California, New York and Texas. 
“When the final numbers started coming out, where a third of the population was on Medi-Cal, it went way past anyone’s expectations,” said state Sen. Ed Hernandez (D-West Covina), who chairs the Senate Health Committee. 
Expanding Medi-Cal was a key part of the Affordable Care Act, the national law that overhauled the healthcare system and required nearly all Americans to have insurance starting in 2014. Under the law, Medi-Cal — historically a health program for poor families and the disabled — was opened to all low-income Californians starting two years ago, with the federal government paying for those new enrollments. 
Though a surprise, the high Medi-Cal enrollment is generally hailed as a success. California’s uninsured population has been cut in half since Obamacare, in large part because so many Californians signed up for Medi-Cal, which is free for beneficiaries. 
“The Medi-Cal program continues to grow at a very substantial rate, which is great. We are very happy that we’re able to provide healthcare to getting close to 13 million Californians,” said Mari Cantwell, chief deputy director at the state Department of Health Care Services, at a hearing in downtown L.A. this month. But, Cantwell added: “Obviously with that comes cost.” 
The question California officials now face is how — and on days with a gloomier economic outlook, if — the massive health program can be sustained. Already, Medi-Cal is seen by many as underfunded, with patients struggling to find doctors and sometimes receiving low quality of care. ...

Friday, January 22, 2016

We Are All Horrible Listeners and Getting Much Worse


Listening Infographic

Year-End Legislation and Regulatory Guidance Impacting Your Health and Welfare Plans

Click here or on the image for a well-done five page summary of year-end legislation and regulation impacting your health plans.

CMS Tightens Qualifying Events for Obamacare - But Effort Woefully Inadequate

These were not the most abused qualifying events. The elimination of these six, mostly obscure, special enrollment rationales will make little to no difference. 

From the New York Times on January 19th:
The Obama administration, responding to complaints from insurance companies, announced several steps on Tuesday that will make it harder for consumers to obtain health insurance after the annual open enrollment period.

Insurers say many consumers have belatedly signed up for coverage under the Affordable Care Act when they become sick and need care. Those latecomers drive up costs for people who sign up during the regular open enrollment period, insurers say. Open enrollment ends this year on Jan. 31.

The administration, which had created more than 30 “special enrollment” periods, sent emails to millions of Americans last year urging them to see if they might be eligible to sign up after the annual open enrollment deadline. But, insurers and state officials said, the federal government did little to verify whether late arrivals were eligible. ...

Mr. Counihan said the administration would eliminate six of the special enrollment periods, including two for certain lawfully present noncitizens who experienced “system errors” and “processing delays” when they used ...

Federal officials said nearly 950,000 people used special enrollment periods to get coverage through from late February to the end of June 2015. In some cases, insurers said, consumers dropped coverage soon after receiving costly medical services. ...

Clare Krusing, a spokeswoman for America’s Health Insurance Plans, a trade group, welcomed the administration’s steps but said they did not go far enough. ...

Insurers had, for example, urged the administration to narrow the “exceptional circumstances” in which the federal government could grant a special enrollment period.

In a blog post on Tuesday, Mr. Counihan said, “Our program integrity team will pull samples of consumer records nationally and may request additional information from some consumers or take other steps to validate that consumers properly qualified for these special enrollment periods.” ...
Here are the eliminated QEs from the CMS blog post:
Eliminating Unnecessary Special Enrollment Periods: Last month, we announced that the Tax Season special enrollment period will no longer be offered. Today we are announcing the elimination of six other special enrollment periods that are no longer needed. Just as the Marketplace evolves, so too does consumer behavior. The rules we use to operate the Marketplace need to keep up with these changes. As such, special enrollment periods are no longer available for:
  1. Consumers who enrolled with too much in advance payments of the premium tax credit because of a redundant or duplicate policy
  2. Consumers who were affected by an error in the treatment of Social Security Income for tax dependents
  3. Lawfully present non-citizens that were affected by a system error in determination of their advance payments of the premium tax credit
  4. Lawfully present non-citizens with incomes below 100% FPL who experienced certain processing delays
  5. Consumers who were eligible for or enrolled in COBRA and not sufficiently informed about their coverage options
  6. Consumers who were previously enrolled in the Pre-Existing Condition Health Insurance Program

Wednesday, January 20, 2016

California Expands on PPACA's SBC Translation Requirements for Health Plans in 2016

California's SB 388 adds translation requirements to PPACA's uniform Summary of Benefits and Coverage (SBC) information. As of July 1, 2016, the Department of Managed Health Care (DMHC) and the California Department of Insurance are to make available on their internet sites written translations of the SBC templates in the required language groups and requires plan sponsors to implement them by October 1, 2016.

Existing Law 

California law requires health plans and insurers to translate vital documents into languages other than English for their non-English speaking enrollees. The languages for which written translations are required are based on the populations served. Documents that must be translated include: applications, consent forms and notices pertaining to the denial, reduction, modification or termination of benefits, and the right to file a complaint or appeal.  This law adds SBCs to that list.

Obamacare requires health plans and insurers to provide consumers with an SBC to help them evaluate and compare insurance options. The SBC include features of coverage such as covered benefits, cost-sharing provisions, and coverage limitations as well as a standard glossary of terms.  In practice however, many enrollees and practitioners in the field have found these SBCs to be confusing, and often inaccurate.  PPACA requires this information to be provided in a “culturally and linguistically appropriate manner.”

Federal guidance on what is culturally and linguistically appropriate is inconsistent with California’s language access rules. The federal rule requires the summary of benefits and coverage be translated when 10% of a limited-English proficient (LEP) population resides in the plan's county.

California’s Translation Requirements Go Further

California law requires vital documents to be translated whenever an (LEP) population is a certain percent of the plan’s enrollment, which holds plans directly accountable for the cultural and linguistic access of their members.

Medi-Cal, for example, defines such a threshold language as a language that has been identified as the primary language of 3,000 beneficiaries or five percent of the beneficiary population, whichever is lower, in an identified geographic area. Thirteen distinct languages qualify as threshold languages, according to a May 2014 Medi-Cal statistical brief. Those languages are:

  • Spanish 
  • Vietnamese
  • Cantonese
  • Armenian 
  • Russian
  • Mandarin 
  • Tagalog
  • Korean 
  • Arabic 
  • Hmong 
  • Farsi 
  • Cambodian, and 
  • other Chinese. 
Spanish is the most frequently occurring, threshold language (34.5 percent) and was represented in the greatest number of counties (49). Los Angeles has the greatest number of threshold languages (12) of any county.

The DMHC also makes available, on its website, threshold languages by health plan. For example, Molina Health Care of California has the following threshold languages identified: English, Spanish, Vietnamese, Chinese, Russian, and Hmong.

California residents speak over 100 different languages and more than 40 percent speak a language other than English. Although federal law requires the SBC to be provided in a culturally and linguistically appropriate manner, the federal definition doesn't reach as far as California's.  In San Francisco, the federal standard for California requires translation into two languages, Spanish and Chinese.  But now under this California law there will be ten languages that meet language access thresholds in San Francisco: Spanish, Vietnamese, Chinese, Korean, Tagalog, Russian, Armenian, Khmer, Arabic and Hmong, with Spanish, Chinese, and Vietnamese being the most commonly required language for translations.


By July 1, 2016, the state will develop written translations of the template uniform SBC for all language groups identified by the State Department of Health Care Services in all plan letters as of August 27, 2014, for translation services pursuant to Section 14029.91 of the Welfare and Institutions Code.  Health plans are to adopt these translations by October 1, 2016.

Tuesday, January 19, 2016

A Few Sentences & 2 Pictures From Today's CBO Report

In 2016, the federal budget deficit will increase, in relation to the size of the economy, for the first time since 2009, according to the Congressional Budget Office’s estimates. If current laws generally remained unchanged, the deficit would grow over the next 10 years, and by 2026 it would be considerably larger than its average over the past 50 years, CBO projects. Debt held by the public would also grow significantly from its already high level.

[F]ewer people will be participating in the labor market than if the economy was operating at its potential.

Potential labor force participation is ... projected to decline as a result of underlying demographic trends and ... federal policies.

The budget deficit increases modestly through 2018 but then starts to rise more sharply, reaching $1.4 trillion in 2026.

Outlays for mandatory programs are projected to rise from their current 13.1 percent of GDP ... to 15.0 percent by the end of the 10-year projection period. That increase is mainly attributable to the aging of the population and rising health care costs per person.

So You Want to Be an Employer? Notable New California Employment Laws, 2016

Because Californians apparently weren’t restricted enough, Governor Brown signed 807 new bills into law for in 2016. I suppose I should not take too snarky a tone, this is quite a bit less than last year’s 931 new curtailments of freedom. Here are a few of the most notable ones impacting businesses and, therefore, employment in the Golden State.

1) E-Verify: to use or not to use?

E-Verify is an internet-based system signed into law in 1996 by Bill Clinton that implements the requirements of federal law by allowing any U.S. employer to electronically verify the employment eligibility of its newly hired employees. E-Verify is a voluntary program for most employers, but mandatory for some, such as employers with federal contracts or subcontracts. It works by electronically comparing the information from an employee’s Form I-9 with records available to SSA and/or DHS to verify the identity and employment eligibility of each newly hired employee. 
  • At least seven states - UT, AZ, AL, MS, SC, GA & NC require employers to use E-Verify. 
  • Most states require E-Verify for state agencies, public employers and/or public contracts. 
  • Only IL and CA limit the use of E-Verify. 
In 2011, Gov. Brown signed AB 1236 into law prohibiting state municipalities from passing mandatory E-Verify ordinances.

And new for 2016, California has expanded the state’s definition of an “unlawful employment practice” to prohibit an employer from using the E-Verify system at a time or in a manner not specifically required by a specified federal law. The law also requires an employer that uses the E-Verify system to provide to the impacted employee any notification issued by the Social Security Administration or the United States Dept. of Homeland Security containing information specific to the employee’s E-Verify case. There is a $10,000 penalty for each employer’s violation.

2) Expansion of Labor Commissioner’s Spanking Stick

This law expands the Labor Commissioner’s authority to enforce judgments. Former law made aggrieved employees’ responsible for collecting their own judgments using the ordinary judicial enforcement mechanisms. This law authorizes the Labor Commissioner to issue a lien on an employer’s property for amounts owed to an employee, such as unpaid wages, and other compensation, penalties, and interest. 
The law also provides that an owner, director, officer or managing agent of the employer may be held personally liable for violations of any provision regulating minimum wages or hours and days of work in any order of the Industrial Welfare Commission.

3) Additional Protection for the Unlawfully Present

The Unruh Civil Rights Act already ensures that "all persons within the jurisdiction of [California] are entitled to full and equal accommodation in all business establishments regardless of their sex, race, color, religion, ancestry, national origin, disability, medical condition, genetic information, marital status, or sexual orientation." The new law extends this protected class categorization to individuals based on their immigration status, citizenship or primary language and mandates full and equal accommodations in all business establishments irrespective of legal residency.

4) Expanded Employee Time Off Required for School Functions

This school-related leave law is expanded to broaden the reasons employees may take job-protected leave from work without the fear of reprisal by mandating that workers be permitted to take time off work to: (1) find, enroll, or re-enroll children in a school or with a licensed child care provider, and (2) to address a child care provider or school emergency.

5) It’s Good to Be a Grocery Store Worker

Assembly Bill 359 protects grocery employees working in stores of at least 15,000 square feet from being fired during a 90-day transition period when the grocery store undergoes a change in ownership. In that process, the new employer must provide a written performance evaluation and consider an offer of continued employment following a satisfactory evaluation. In a display of unprecedented kindness, the state will allow employers retain the right to terminate an employee for cause at any time during and following the transition period. It is the first statewide law in the nation requiring grocery stores to retain employees after a change in ownership.

6) Professional Sport Team Cheerleaders Are Now “Employees” By Law

Syrian refugees may have thought they had it bad. But unless and until they’ve spoken California’s professional cheerleaders, I don’t think they have any idea how rough things can get.

AB 202 requires California-based minor or major league baseball, basketball, football, ice hockey, or soccer to treat cheerleaders as employees, not independent contractors, when they perform during exhibitions or games. This means that California cheerleaders are now afforded the full protection of all California employment laws, including protections against discrimination, harassment, and retaliation as well as minimum wage protection, unemployment insurance, potential medical benefits under Obamacare and workers’ compensation. Cheerleaders typically made $125 per game where they were, in essence, auditioning for acting, other dancing, or reality TV gigs while having fun at a professional sporting event. The state of California has made that arrangement illegal and greatly increased the cost of cheerleaders, casting doubt on their future in the state. 

Monday, January 18, 2016

Quality Guidance on When to Extend or Deny an Extension of FMLA Under the ADA

Here is some wise counsel from a session featuring FMLA Insights founder Jeff Nowak and EEOC Commissioner Chai Feldblum as reported in HR Morning by Tim Gould:
[O]nly conducting the undue hardship analysis after an employee has already exhausted his or her FMLA leave [is a mistake]. ...[B]usinesses can assess whether additional leave will present an “undue hardship” on “day one” of an employee’s FMLA leave. And to present a solid case for undue hardship, they should probably be doing just that. ...

[T]he specific factors that can help an employer deny additional leave as a reasonable accommodation ... include...:
  • Significant losses in productivity because work is completed by less effective, temporary workers or last-minute substitutes, or overtired, overburdened employees working OT who may be slower and more susceptible to error
  • Lower quality and less accountability for quality
  • Lost sales
  • Less responsive customer service and increased customer dissatisfaction
  • Deferred projects
  • Increased burden on management staff required to find replacement workers, or readjust workflow or readjust priorities in light of absent employees, and
  • Increased stress on overburdened co-workers. 

Tuesday, January 12, 2016

Enrollees Gaming Obamacare Drive Claim Costs Through the Roof

Enroll when you get sick and then drop coverage

The New York Times is reporting that the Obama administration has created more than 30 “special enrollment” categories allowing folks to enroll in Obamacare outside of a normal enrollment period.  That has allowed people to wait until they become ill or need medical services to sign up, driving up costs significantly.

Individuals enrolled through these special enrollment periods are utilizing up to 55 percent more services than their open enrollment counterparts.

It leaves individuals with no incentive to enroll in coverage during open enrollment as most can simply wait until they are sick or need services before enrolling and drop coverage immediately after receiving services.

And some of these special enrollment qualifiers are far less than ironclad.  Consumers may, for example, be eligible for a special enrollment period in “exceptional circumstances” and in “other situations determined appropriate” by the Centers for Medicare and Medicaid Services. The circumstances may include “a serious medical condition” or “misinformation” about a healthcare plan that interfered with normal plan enrollment.

Full story from NYT.

Monday, January 11, 2016

Companies Spawn to Shift Healthcare from Employer to Taxpayer

If you liked your plan, you are going to love Medicaid. 

... Employers have not historically played a significant role in helping workers enroll in Medicaid. But Gillingham’s insurance broker told him about a startup called BeneStream, which is based in New York City and facilitates enrollment in the government program. 
Company Shifts Insurance Costs To The Government 
Founded two years ago with seed money from the Ford Foundation, BeneStream now helps more than 6,500 workers at 125 companies across the country get Medicaid. CEO Benjamin Geyerhahn said moving workers from private insurance to Medicaid helps firms shift their costs to the government. 
“The savings is quite significant,” he said. “Our average is about 250 percent — so about two-and-a-half times the money you spend on us comes back to you in the form of saved premium.” ...

Friday, January 8, 2016

How is Obamacare Working? My Comments and Audio from Armstrong & Getty 1/7/16

I took a couple of weeks off from the daily grind of PPACA during the holidays but Joe Getty asked me to comment on an article he'd read in The Hill on ObamaCare's strengthened standing in 2016.  I sent him a fairly detailed, point by point, rebuttal. His summary of it was outstanding.

The audio is below, enjoy.

Wednesday, January 6, 2016

How Has the Congressional Budget Office Done in Forecasting Obamacare? Reasonably Well

Interesting little study from Commonwealth:
  • CBO overestimated Obamacare enrollment by 30%; 
  • It overestimated Marketplace costs by 28%; and 
  • It underestimated Medicaid enrollment by 14%. 
Not too bad considering how incredibly difficult some of this can be to quantify.  

Between 1999 and 2015, Premiums Increased by 203%

Great graphic from JAMA and KFF:
Between 1999 and 2015, premiums increased by 203%, outpacing both inflation and workers’ earnings.