More Confirmation That Affordable Care Act Lowers Deficits While Bringing Insurance to 30 Million Uninsured Americans

The Affordable Care Act is the opposite of an unaffordable new entitlement; it is a way to insure 30 million more people while reducing the federal government’s deficit at the same time, according to today’s report from the nonpartisan Congressional Budget Office, which is the closest thing that the United States has to an unbiased financial umpire.

CBO also scored the budgetary impact repealing the health reform law, as endorsed by Mitt Romney and House and Senate Republicans. They found that repeal would add to the deficit while also taking away the insurance that those 30 million people would have gained. In addition, repeal would overturn rules that bar insurance companies from denying coverage due to pre-existing conditions, from canceling coverage when people become ill, and from placing a lifetime dollar limit on coverage. Other provisions that repeal would reverse are the phase-out of the “donut hole” where seniors have no Medicare coverage for prescription drugs, the right of young adults to remain on their parents’ insurance policies through age 26, and the requirement that insurance companies spend at least 80 or 85% of premium dollars (depending on the type of policy) on health services rather than administration and profits.

Also prohibited under the law starting in 2014 will be annual coverage limits and gender discrimination (women currently can be charged higher rates than men for the same coverage).

From Jon Cohn’s new article in The New Republic:

The Congressional Budget Office just published a newly updated estimate of the Affordable Care Act and its impact on the budget. The estimate largely tells us what we already knew: The law, when fully implemented, will dramatically reduce the number of Americans without health insurance. It will also reduce the deficit.

This last part remains a big deal, if only because so many conservatives—and, yes, so many members of the public—refuse to believe it. Over and over again, you hear people saying that Obamacare will run up the deficit. The CBO, which is our most reliable guide on such matters, begs to differ. 

CBO can’t be certain, because nobody can be certain, how exactly the law will play out. But the best available evidence suggests that, in the end, the law will leave the federal treasury with more money than it would have otherwise. And that’s just in the short- to medium-term. If the program’s efforts at re-engineering the health care system really work, then all spending on health care—from the federal government, corporations, and individuals alike—will stop rising so quickly, freeing up more money for other purposes (like, for example, raises to employees).

The Supreme Court Speaks, Health Reform Continues

My editorial on the health reform law has been posted as part of the new issue of Health Insights Today, here. There’s a focus on the potential effects of the law for chiropractic and CAM, along with broader societal effects that will come with implementation (or repeal).

I hope you all click through to the full editorial. Here’s an excerpt.

First, the landmark provider nondiscrimination rule, Section 2706:

Since most readers of Health Insights Today have a strong interest in chiropractic and complementary and alternative medicine (CAM), let’s begin with the provisions directly related to those fields. First and foremost, the Affordable Care Act’s Section 2706 enacts for the first time a nationwide provider nondiscrimination policy, prohibiting insurance companies from denying coverage based on provider type for services provided by licensed health care practitioners. For example, this policy appears to indicate that if spinal manipulation or acupuncture (or any other service within a practitioner’s scope of practice) is covered when performed by a medical or osteopathic physician, insurers cannot have a policy denying such coverage when the service is performed by a chiropractor or acupuncturist. In the past, such discriminatory policies have had the effect of routing patients away from DCs, LAcs and other non-MD/DO practitioners.

The nondiscrimination rule is a landmark step forward and marks the first time that legislation applies such a policy across the entire nation. However, it does not bar all forms of discrimination. Importantly, insurers are not barred from paying some types of practitioners more than others for the same services. Chiropractors and a variety of other non-MD/DO practitioners sought such a ban but did not achieve it in this legislation. Success on that front will have to wait until later.

The full ramifications of Section 2706 will become clearer over time, as uncertainties are resolved through state and/or federal regulatory actions or litigation. For now, it is seen by chiropractic and CAM leaders and attorneys as the most significant piece of federal legislation in many years. The American Medical Association House of Delegates approved a resolution at its June 2012 national meeting that calls for the repeal of the nondiscrimination policy. While vigilance on the part of chiropractic and CAM organizations remains necessary, this AMA repeal effort faces a steep uphill climb unless the November 2012 election brings a president, House, and Senate that repeals the entire Affordable Care Act. Senate Republican Leader Mitch McConnell and House Speaker John Boehner have pledged to seek full repeal in early 2013. 

I ask each of our readers … please familiarize yourself with what is in the law, so that you will be able to evaluate all claims — pro or con — based on facts rather than distortions.  

 

 

 

Cancer v. the Constitution

A human tragedy, which could become much less common or much more common depending on what the Supreme Court decides.

She hadn’t gone to the doctor because she had no health insurance. The only kind of work she could get in a struggling rural community was without benefits. Her coat and shoes beside the gurney were worn and her purse from another decade. She could never afford to buy it on her own. She didn’t qualify for Medicaid, the local doctor only took insurance, and there was no Planned Parenthood or County Clinic nearby.

So nothing was done about the bleeding until she passed out at work and someone called an ambulance. She required a couple of units of blood at the local hospital before they sent her by ambulance to our emergency department.

I looked at the fungating mass on her cervix. Later the Intern wondered why she hadn’t picked up on the smell. Probably a combination of it being so gradual and denial. It’s amazing what people learn to tolerate when their options are limited.

“I’m very sorry to tell you this looks like a cancer of the cervix,” I said

She looked surprised. “Oh.” She paused in silence as she adjusted to the news. And then quietly she added, “But the doctor back home said you could fix me up. He said you can offer free care because you have the university.”

But we didn’t have free care at the university hospital.

h/t Meteor Blades