Obama finally embraces the Republican term 'Obamacare'

“The Obama administration made a decision on Friday to own the term‘ObamaCare’,” NBC News reports in its First Read blog, adding a capital letter not often used. “It had been used as a pejorative by Republicans, but the White House has made the decision to embrace it and not let opponents have a word that they only drive as a negative. White House senior adviser David Plouffe noted on ‘Meet the Press’ Sunday that, in 10 years, health care will be a positive and cited polling that people don’t want to re-litigate it. We can report that last part came from Democratic polling Plouffe has seen; he was not citing any public polling on this specific issue.”

The NBC item is also based on a story yesterday from The New York Times, which reported that Democrats are “launching a Twitter campaign that seeks to build positive associations for it.” The Twitter post read, “If you’re proud of Obamacare and tired of the other side using it as a dirty word, complete this sentence: #ILikeObamacare because ...”

The story noted that “Obamacare” has been used “primarily by Republicans, as a term of disdain. Democrats have tried to limit the term’s use to reshape perceptions, but that has been a tough sell.” The Times quotes Grant Barrett, a vice president for the American Dialect Society, who said that once a word becomes political, it is very difficult to quash it: “It’s an invitation to have your heart broken. You forbid it, and they start writing it on the bathroom stalls.”

For the Times story and a nice graphic showing the history of the term, and examples of its use, by Amanda Cox, Alicia DeSantis, Alicia Parlapiano and Jeremy White, click here.

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Conflicting interpretations abound regarding CBO's report about cost, coverage of Affordable Care Act

By Tara Kaprowy
Kentucky Health News

Since the Congressional Budget Office released a report with revised estimates about how many people the Affordable Care Act will cover and how much it will cost, it has spawned a whirlwind of op-ed pieces with vastly opposing interpretations.

According to Julian Pecquet in The Hill, the estimate showed the federal health-care reform law will allow 30 million more people to get insurance coverage by 2016, down from the previous estimate of 32 million. Thus, the law's coverage provisions are now estimated to cost $1.083 trillion over the next 10 years, $50 billion less than last year's projection.

The CBO also estimates that 4 million Americans will lose their employer-sponsored health insurance by 2016, not the mere 1 million figure projected last year. It also estimates that 1 to 2 million fewer people will qualify for state health-insurance exchanges than initially thought, but an additional 1 million will qualify for Medicaid or the Children's Health Insurance Provision, known in Kentucky as K-CHIP.

"CBO faults a slower than anticipated recovery for the soft numbers, along with technical changes to CBO's estimating procedures and legislative changes adopted over the past year," Pecquet reports. The changes in cost estimates are "due in part to slower growth in health-care spending resulting in an 8 percent drop in premiums, as well as taxes and penalties paid by employers and their workers as struggling businesses cut down on employer-sponsored coverage," Pecquet writes.

Conn Carroll, senior editorial writer for The Washington Examiner, has an entirely different view, saying the cost has doubled. "The gross cost of President Obama's health care law has risen from $940 billion when the bill was passed, to $1.76 trillion today. This did not sit well with Obamacare's leftist apologists," he writes. Carroll uses gross figures to arrive at his calculations.

Carroll is comparing apples to oranges, and the estimate hasn't doubled, writes Ezra Klein of The Washington Post. "The disparity in the cost estimates only comes when you take a different sample of years, in which the law is doing different things, in an economy of a different size. And even then, costs went up only if you take "gross" costs rather than "net" costs, which is a rather unusual way to think about the budget."

Paul Krugman of The New York Times weighs in too, but not on the numbers. He does say, "For all its imperfections, this reform would do an enormous amount of good. And one indicator of just how good it is comes from the apparent inability of its opponents to make an honest case against it."

Krugman said "most of the disinformation" about the reform is about costs. "Each new report from the Congressional Budget Office is touted as proof that the true cost of Obamacare is exploding, even when — as was the case with the latest report — the document says on its very first page that projected costs have actually fallen slightly."

CBO Director Douglas Elmendorf defended in his blog the changes in estimates. "We will continue to update our estimates regarding health insurance coverage as new information becomes available about the implementation of the ACA, underlying trends in the health-care and health financial systems, and the probable responses to the legislation by businesses, families and others."

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Affordable Care Act helping families, seniors in rural areas, agriculture secretary says on its second anniversary

The Patient Protection and Affordable Care Act is already making an impact, including for people who live in rural America. That was the message from Agriculture Secretary Tom Vilsack today on the second anniversary of the enactment of the federal health-care reform law.

In a teleconference, Vilsack noted several pieces of the law that are benefitting people, including the 2.5 million young adults who have insurance coverage because parents can keep them on their plan up to age 26. "That's providing a degree of comfort to moms and dads," he said.

The law has also helped 3.6 million seniors on Medicare, who saved $2.1 billion on their prescription drugs in 2011 because the law allowed them to get a 50 percent discount on brand-name drugs. Vilsack said seniors saved an average of $600 last year and were also "able to get a number of services, including preventive services like mammograms, for free."

Under the law, insurance companies are now required to spend 80 percent of their premium dollars on "actual health care, not overhead," Vilsack said, and they are not allowed to increase their premiums by more than 10 percent without an explanation. Children who were previously denied coverage because of pre-existing conditions can no longer denied, as per the law's mandate, and "in a couple of years that will extend to all people," Vilsack said. And thousands of new primary-care doctors and nurses are being encouraged to practice in rural areas and will receive higher payments.

Vilsack said his Department of Agriculture is working to improve the rural health-care landscape, through a joint effort with the USDA Rural Development division and the Department for Health and Human Services. In the past three years, Vilsack said 730 counties have received grants so they can "embrace telemedicine." Nearly 600 health-care facilities in rural communities have received money to fund equipment like CT scans, MRIs, ultrasound and lab equipment, Vilsack said. And rural citizens can now get care from a hospital outside their health plan's network when there is no time to get to a hospital that is farther away.

"No one should have to go without health care because of where they live, and for too long, rural Americans have been getting the short end of the health-care stick," he said. "The Affordable Care Act is helping millions of young people access health care, strengthening Medicare, and training thousands of new doctors to serve rural areas to give middle-class families the health security they deserve." (Read more)

Reform act good for kids, Kentucky Youth Advocates head says

This week marks the second anniversary of the Affordable Care Act and debate about its cost and benefits continues to be vigorous. But one thing that can't be denied "is that the ACA, on a most basic level, benefits vulnerable kids in Kentucky," writes Terry Brooks, right, executive director of Kentucky Youth Advocates, in an op-ed piece in the Lexington Herald-Leader.

"Today, because of the ACA, kids with pre-existing conditions like diabetes and asthma can't be denied the care they need," he writes. "And children across Kentucky are receiving preventive care like immunizations without their parents having to pay out-of-pocket costs so they can avoid illness and we can avoid unnecessary health care costs for preventable problems."

Brooks also notes that the ACA allows children to be covered under parents' insurance up to age 26.

If provisions of the ACA are not revoked, children can continue to benefit into their adulthood, Brooks writes: "They'll be protected from their insurance companies placing lifetime caps on their coverage and benefits, so if a child beats leukemia at age eight, she will still be able to get the care she needs if she relapses at age 20." That will translates to 360,000 children in Kentucky being protected. "And more than 180,000 Kentucky children will be able to receive preventative care such as well-child visits and other screenings with no out-of-pocket costs," he writes.

"So, yes, let's debate the pros and cons," he said. "But let's not deny the simple fact that the ACA is good for kids, and kids should be spared from the politics and animosity of this debate." (Read more)

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Will birth-control mandate cost more or less? Yet to be seen

Will requiring insurance companies to provide contraception be cost-neutral, as the Obama administration claims? It is unclear, and so is whether insurance companies will make Catholic institutions pay more. These were the findings of FactCheck.org, a nonpartisan, nonprofit, consumer-advocate project funded by the Annenberg Public Policy Center of the University of Pennsylvania.

In support of its claim, the administration cites data from Hawaii's birth-control mandate, which shows health insurance premiums "did not appear" to increase. The study also found the number of pregnancies increased after contraception coverage was required.

But when Pennsylvania considered imposing a similar mandate, a state agency found "the amount of possible savings relative to the cost of the legislation is unclear." Findings were also unclear in Connecticut when officials there looked at whether or not insurance plans saved enough because there were fewer pregnancies to offset the cost of providing coverage. A Texas study found insurance companies would not save enough because women would buy contraception on their own.

A recent survey of 15 insurance companies found six thought costs would increase and another three felt the move would be neutral in cost. None felt they would save money because of the mandate.

"Until better data are available, we're unable to conclude whether the Obama birth-control mandate is likely to result in a net cost increase or not," FactCheck reports.

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New survey shows dramatic increase in employer-sponsored health insurance rates

The average cost of employer-sponsored health insurance has increased 9 percent for family coverage and 8 percent for individual coverage since last year, a new study by the Kaiser Family Foundation and the Health Research & Education Trust shows. "Both increases are the largest since 2005," Tony Pugh of McClatchy Newspapers writes, surpassing the national 2 percent increase in wages and 3.2 percent increase in inflation.

Since 2001, family coverage premiums have escalated 113 percent while workers' wages have only risen 34 percent and inflation – 27 percent, Pugh reports. Researchers are unclear if the increase in premiums is temporary or whether higher increases will continue. "We really don't know, and we won't know until next year," Drew Altman, president and CEO of the Kaiser Family Foundation told Pugh.

Employers pay on average about 72 percent toward family coverage and 82 percent for single coverage, Pugh reports, leaving workers paying 28 percent for family and 18 percent for single coverage. Of those surveyed, about 31 percent of covered workers were in high-deductible plans, a 10 percent increase from 2006.

Increasing costs in medical care is "the main culprit behind the rate increases," Karen Ignagni, president of America's Health Insurance Plans told Pugh. "Insurers' expectation of stronger economic recovery" and insurers' fears of increased costs from the 2010 Affordable Care Act may be driving higher premiums, Pugh reports.

Despite insurers' fears, an analysis by Kaiser and the federal government suggest that the 2010 Affordable Care Act accounts for only 1 to 2 percentage points of the increase. Only two measures, coverage of adult children to age 26 and no patient cost-sharing coverage on certain preventive medical services, were implemented thus far with the remaining provisions taking effect in 2014, Pugh reports. This month, insurers will be required to publicly disclose information about rate increases of 10 percent or more for review by state or federal officials to determine if the increase is warranted. (Read more)

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