Are Insurers Prevailing Over Drug Makers?

Less than a year ago, it looked like health insurers were sending up trial balloons to see if they could get the federal government to regulate the research-based pharmaceutical industry as a utility. This was a reaction to high prices for new drugs like Sovaldi®. Today, the issue is being dialed back.

Read the entire entry at NCPA's Health Policy Blog.

"Transparency" Will Not Fix Medicare Physician Fees

The Government Accountability Office (GAO) has released a report criticizing the way the federal government sets physicians’ fees in Medicare. It concludes that “Better Data and Greater Transparency Could Improve Accuracy.”

I doubt it. Note the mind-numbing detail of this process: The government delegates this authority to a group of physicians who comprise the Relative Value Scale Update Committee (RUC). The government “reviewed 1,278 RUC work relative value recommendations for about 1,200 unique (new and existing) services)” in the last four years.

Read the entire entry at NCPA's Health Policy Blog.

Think Of The Worst Corporate Merger Ever - Then Add Obamacare

I hate to recycle the old slight about “re-arranging the deck chairs on the Titanic,” but the latest news from state exchanges really makes it impossible to avoid:

Under the Affordable Care Act, the federal government gave states a collective $4.8 billion to set up and customize their own exchanges for their own state residents. The idea was that the federal government would help prop up the exchanges, and then states would have to make them self-sustainable by this year.
However, a number of states including California and Oregon are having trouble financing their exchanges now that federal funding is drying up. Covered California, for example, is running a deficit of $80 million.
To save on costs, California is reportedly in talks with Oregon, another state struggling to afford its exchange, to merge their exchanges, The Hill first reported.
They’re not alone. Other states are contemplating building similar multi-state exchanges. New York and Connecticut are also discussing the plan, though both are in the very preliminary stages. (Brianna Ehley, “States Band Together to Keep Obamacare Afloat,” The Fiscal Times, May 26, 2015)

Read the entire enrty at NCPA's Health Policy Blog.

Health Spending Unscathed in Shrinking Economy

This morning’s terrible revision to first quarter GDP – from an initial estimate of 0.2 percent real growth to a real loss of 0.7 percent – confirms that health spending stands over our weak economy like a colossus.

In the initial estimate, personal consumption spending on health services increased by $23 billion (chained 2009 dollars). Today’s second estimate reports $24.2 billion (Table 3, line 17). So, we can be pretty confident that the folks at the Bureau of Economic Analysis who do this good work have mastered how to measure spending on health services.

This emphasizes how much of our prosperity is being devoured by a health system that is still driving everyone crazy, post-Obamacare. The real drop in GDP was a loss of $30.6 billion.

Read the entire entry at NCPA's Health Policy Blog.

Single Payer Extremists: Obamacare Has Increased Health System Overhead

Drs. David Himmelstein and Steffie Woolhander are the Bernie Sanders of health policy. For decades, they have advocated that the U.S. adopt a government monopoly, single payer, health system. They write economically illiterate articles asserting that Medicare is great because it has low administrative costs.

Nevertheless, a stopped clock is right twice a day, and the good doctors’ latest article nails Obamacare for increasing the overhead of U.S. health insurance. Who would have even thought that was possible?

Read the entire entry at NCPA's Health Policy Blog.

Can You Pay Poor People To Quit Smoking?

Peter Orszag was President Obama’s first Director of the Office of Management and Budget. Like many high-ramking Democrats, he landed on his feet as Vice Chairman of Citibank. He also writes a very good column for Bloomberg View.

His latest column discusses financial incentives to quit smoking. Unfortunately, it ignores an obvious challenge to the thesis he supports: That poor people can be paid to quit smoking.

Read the entire entry at NCPA's Health Policy Blog.

Headwinds for Health Insurers as Obamacare Stumbles

You might think this headline is a gag, given how deeply health insurers are dug into Obamacare. Only a month ago, I wrote that health plans’ mastery of Obamacare poses challenge to repeal. Losses in Obamacare’s controversial exchanges are not yet apparent in the publicly listed insurers’ financial statements.

However, exchanges comprise of a small (but not trivial) market of about 11 million people. Through 2016, health plans losing money in Obamacare can rely on taxpayers to help them out. After that, they are on their own.

Already, many plans are finding participation painful and increasing Obamacare premiums significantly for 2016, according to Louise Radnofsky of the Wall Street Journal,

Health insurers might not think the unravelling of Obamacare will hurt them too much. (Certainly, their investors do not). Nevertheless, these rate hikes increase the political risk of their participating in markets they do find profitable.

Read the entire article at Forbes.

Preventive Care Does Not Want to Be Free

One conceit behind Obamacare is that if the government mandates preventive care be “free”, people will use it. The notion should appeal to free-market types, too: As the price of a service drops, the quantity demanded should increase.

However, it is not that simple in health care. Let’s take another dive into the always heated and controversial discussions about preventive care for women (such as our recent entry about mammography).

New research shows that women under 65 are over screened for osteoporosis, and women aged 65 and over are under screened, although older women get screened for “free."

Read the entire entry at  NCPA's Health Policy Blog.

Price's Health Reform Hit From The Right

I recently discussed Rep. Tom Price, MD’s Empowering Patients First Act in quite positive terms. Not everyone is on board. My good friend Dean Clancy labels the bill "Health Care Cronyism."

Read the entire entry at NCPA's Health Policy Blog.

Most Employers Will Use Private Benefits Exchanges By 2018

A new survey from Array Health reports four of five insurance executives anticipate that most employers will use private exchanges to offer benefits by 2018. According to the survey, private exchanges are a win-win situation because they reduce administrative costs.

We like private exchanges because they pave the way for individual health insurance to be the standard. The Array report seems to support this conclusion.

Read the entire entry at NCPA's Health Policy Blog.

Obamacare Premiums Spiking in Obamacare, Kansas

Obamacare Premiums Spiking in Iowa, Kansas

We’ve already learned about Obamacare’s 2016 premiums exploding in New Mexico, Tennessee, Maryland, and Oregon. More are being announced.

Read the entire entry at NCPA's Health Policy Blog.

Breast Cancer Screening Update

ou may recall controversy circa 2009 and 2010, when the Affordable Care Act was passed, about whether women in their 40s would get “free” mammograms every year. In 2009, the US Preventive Services Task Force issued guidelines recommending annual mammograms starting at 50 years, not 40 (as previously recommended).


The USPSTF looks ready to re-issue its guideline, which means “free” mammograms for women in their 40s will not be mandated by Obamacare. Avalere Health has published a study estimating that this could “eliminate guaranteed coverage” for 17 million women.

Read the entire entry at NCPA's Health Policy Blog.

Maybe the Government Should Just Not Ask People if They Are Uninsured

Sir John Cowperthwaite was the Financial Secretary of the British Colony of Hong Kong when it began to boom in the 1960s:

Asked what is the key thing poor countries should do, Cowperthwaite once remarked: “They should abolish the Office of National Statistics.” In Hong Kong, he refused to collect all but the most superficial statistics, believing that statistics were dangerous: they would led the state to to fiddle about remedying perceived ills, simultaneously hindering the ability of the market economy to work. This caused consternation in Whitehall: a delegation of civil servants were sent to Hong Kong to find out why employment statistics were not being collected; Cowperthwaite literally sent them home on the next plane back. (Alex Singleton, The Guardian)

What does this have to do with health insurance? The Wall Street Journal’s Jo Craven McGinty reports on the Census Bureau’s rejigging of its measurement of how many Americans are without health insurance.

Read the entire entry at NCPA's Health Policy Blog.

New Ventures Make Obamacare Exchanges Less Relevant Than Ever

One theme of this blog is that Obamacare exchanges make as little sense for health insurance as a DMV-operated exchange for car insurance, or a HUD-operated exchange for homeowner’s insurance. Just shut them down.

We’re not the only ones who noticed.

Read the entire entry at NCPA's Health Policy Blog.

Price's Empowering Patients First Act Gets Better With Age

You’ve got to give credit to Congressman Tom Price, MD: He introduced his first post-Obamacare bill as early as 2009 and has reintroduced an updated version in every Congress since then. The latest Empowering Patients First Act (H.R. 2300), introduced this month, is the fourth iteration.

The most important improvement is a universal tax credit, adjusted by age, to every American who chooses to buy individual health insurance: $1,200 for those aged 18 to 35, $2,100 for those between 35 and 50, $3,000 for those over 50 and $900 per child. Dr. Price’s previous bill had tax credits, which were not adjusted by age, but by income. Of course, Obamacare’s tax credits phase out by income, which causes very high effective marginal income tax rates at certain income thresholds.

Read the entire column at Forbes.

"Uninsurance" Unchanged Under Obamacare

Yet another pro-Obamacare organization has had to publish a study indicating that Obamacare is failing to achieve its objectives. I recently discussed Families USA’s report that one third of low income families cannot afford care under Obamacare.

This time it is the Commonwealth Fund, inventor of the notion of “underinsurance,” which is defined as out-of-pocket health costs (excluding premiums) comprising at least 10 percent of household income, or five percent if household income is less than 200 percent of the Federal Poverty Level.

In 2014, the proportion of so-called “uninsured”, aged 18-64, was 23 percent – exactly the same as in 2012 and just one percentage point more than in 2010.

Read the entire entry at NCPA's Health Policy Blog.

The Clinton Foundation's Health Care Funders

Here is a list of the U.S.-based businesses, professional & trade associations, charities, individuals, and academic institutions in the healthcare sector who have given at least $100,001 to the Clinton Foundation, either as donations or speaking fees, compiled from the foundation’s website

Read the entire entry at NCPA's Health Policy Blog.

Obamacare Premiums Explode

The Wall Street Journal has reviewed health plans’ rate filings for 2016 in Obamacare exchanges:

In New Mexico, market leader Health Care Service Corp. is asking for an average jump of 51.6% in premiums for 2016. The biggest insurer in Tennessee, BlueCross BlueShield of Tennessee, has requested an average 36.3% increase. In Maryland, market leader CareFirst BlueCross BlueShield wants to raise rates 30.4% across its products. Moda Health, the largest insurer on the Oregon health exchange, seeks an average boost of around 25%.
All of them cite high medical costs incurred by people newly enrolled under the Affordable Care Act. (Louise Radnofsky, “Health Insurers Seek Healthy Rate Boosts,” May 21, 2015)

Readers of this blog knew that this death spiral was coming. What is remarkable is that it is happening now. Things must be worse than insurers are disclosing to make them jack rates so high, so soon.

Read the entire entry at NCPA's Health Policy Blog.

High U.S. Health Prices from Market Power?

The National Academy of Social Insurance (NASI) recently published a consensus report on provider consolidation. Basically, we have a growing problem in that hospitals are buying each other up and also physician practices, which leads to reduced competition and higher prices.

These are remarkable statements; and difficult to accept uncritically.

Read the entire entry at NCPA's Health Policy Blog.

Senator Cassidy's King v. Burwell Obamacare Alternative Should Be A Winner

Senator Bill Cassidy. MD (R-LA) has introduced the Patient Freedom Act, in anticipation of the Supreme Court deciding for the plaintiffs in King v. Burwell, the lawsuit that seeks to force the administration to obey the law by not paying tax credits to health plans operating in states using a federal health insurance exchange (i.e. healthcare.gov).

Victory for the plaintiffs this summer would cause significant disruption in health insurance in the 34 to 37 states without their own exchanges because premiums for up to nine million people would increase significantly. Many would choose to drop coverage if and when they have to face paying full premium for their policies.

Americans have had their health coverage upended not only by the Affordable Care Act, but also by the allegedly illegal execution of the law by the administration. Congress has a duty to respond to a court victory with a new law. However, it has to be one that the president will sign, but will not leave the Republican-majority Congress’ fingerprints on Obamacare. This is a tricky needle to thread.

Dr. Cassidy believes he can achieve this by restoring federal funding to states that will lose tax credits, but freeing them from Obamacare.

Read the entire column at Forbes.

Families USA: One Third of Low-Income Obamacare Beneficiaries Cannot Afford Care

One of Obamacare’s biggest cheerleaders, Families USA, has published new research showing that one third of low-income Obamacare beneficiaries have not obtained medical care due to cost in 2014:

But don’t you worry, Families USA has not thrown in the towel on Obamacare yet:

Read the entire entry at NCPA's Health Policy Blog.

Medicare Moratoria Miss the Mark

On May 19, the U.S. House of Representatives Committee on Ways & Means, Subcommittee on Health will be having a hearing on improving competition in Medicare by removing moratoria and expanding access. Medicare fraud is a serious problem. The Medicare bureaucracy has the power to impose moratoria on new providers in geographic or program areas it deems susceptible to fraud.

However, preventing new competitors from providing Medicare benefits reduces competition and cannot reduce fraud by incumbent providers. A better way would be to give Medicare beneficiaries a financial interest in combating fraud.

Read the entire column at Forbes.

Certificate of Need Laws Reduce Choice in Health Care

Imagine if you wanted to open a new hardware store and you needed a “Certificate of Need” issued by the state or local authority that your hardware store was needed. Needless to say, incumbent hardware stores would already be well armed with strong arguments that your hardware store was not needed. Crazy? Yes. Un-American? Yes. Unfortunately, these Certificates of Need exists in most U.S. states for hospitals or other facilities.

Scholars at the Mercatus Center have published a new ranking of states’ CON laws, finding that sates with Certificate of Need programs are associated with:

• 131 fewer beds per 100,000 persons.
• A reduction by between 1 and 2 hospitals providing MRI services per 500,000 persons.
• A reduction of 37 percent in the number of hospitals offering CT scans.

Read the entire entry at NCPA's Health Policy Blog.

Did A Health Insurer Pay Ten Times the Cash Price for Surgery?

A strange story out of Arizona about hosptial billing run amok is standard fare these days.
However, this one has a silver lining: The patient had actually been able to figure out what the cash price would be if she paid directly herself. It has previously been hard for cash-paying patients to avoid being gouged by hospitals unless they are Canadian medical tourists. Whether this story is idiosyncratic or symptomatic of a trend, I cannot say. I hope it is the latter.

Read the entire entry at NCPA's Health Policy Blog.

Successful Health IT Deals Are Obamacare Agnostic

Obamacare has definitely benefited the health sector. However, many successful new health IT ventures have prospects quite independent of Obamacare’s risky future. Rather, they appear robust in the face of a wide range of possible futures for U.S. health reform.

Because health care is so dependent on government, it is not surprising that adoption of effective IT in health care has lagged behind other sectors, where suppliers have to rely on customers — not government — for revenue. Nevertheless, even a sector so politically protected from disruption as U.S. health care must eventually give way to change. Three examples show this change can come from different directions, despite Obamacare’s straightjacket.

Read the entire column at Forbes.

Hawaii's Obamacare Exchange Closing After Spending $205 Million

If a tax credit falls from Washington, and no Obamacare exchange receives it, what subsidy does it make?

Read the entire entry at NCPA's Health Policy Blog.

Heave Employer-Based Health Benefits Dropped?

Just the other day, my analysis of the RAND Corporation’s survey of health insurance from September 2013 through February 2015 led me to conclude that “economic growth improved coverage more than Obamacare did.”

However, there are other sources that contradict the RAND survey’s conclusions about employer-based benefits. My Forbes colleague Scott Gottlieb, MD, reviews a new report from Goldman Sachs that estimates small employers dropped 2.2 million beneficiaries from coverage, a reduction of 13 percent from 2013.

Last year, Ed Haislmaier and Drew Gonshorowski of the Heritage Foundation concluded that nearly 3.8 million people lost employer-based coverage through June 2014.

Both the Goldman Sachs and Heritage Foundation analysts relied on data from insurers rather than beneficiaries. Nevertheless, I am at a loss to understand how people who lost employer-based benefits would not say so in a phone survey.

Read the entire entry at NCPA's Health Policy Blog.

Electronic Health Records: Not Just An American Problem

In Australia, the Liberal-National coalition government has decided to scrap the nation’s Electronic Health Record, blaming the previous Labour government for the current one’s failings. Unfortunately, the government plans to replace it with a new one, instead of leaving well enough alone.

Read the entire entry at NCPA's Health Policy Blog.

Malpractice By Electronic Health Record

Arthur Allen of Politico exposes yet another reason for doctors to fear Electronic Health Records: Their errors lead to lawsuits. Readers of this blog know why they are selling despite their serious flaws: The government has thrown almost $30 billion at hospitals and physicians to cause them to buy them.

Read the entire entry at NCPA's Health Policy Blog.

Doctors Beware: Electronic Health Records Debacle Will Get Worse

More and more people are having the disturbing experience of seeing their doctors spend more time pecking at a computer keyboard than examining them. The doctors are entering data into their patients’ electronic health records (EHRs) in compliance with federal rules introduced a few years ago.

EHRs drive doctors crazy. Their own experience tells them that electronic recordkeeping interferes with care, by taking time away from patients. In a survey conducted by the Deloitte consulting group, three of four doctors said EHRs are not worth the cost. The influential RAND Corporation, which had long endorsed EHRs, reported in 2013 that they neither saved money nor improved care.

A bipartisan bill recently passed by Congress will make this worse.

Read the entire op-ed at the American Thinker.

Economic Growth Improved Health Coverage More Than Obamacare Did

The RAND Corporation has published a thorough analysis of Obamacare’s effect on health insurance that should have put an end to the Obamacare success narrative. Unfortunately, too many continue to confuse the effect of the delayed recovery with Obamacare. What the RAND study really shows is that employer-based benefits have been restored as jobs have started to come back.

Read the entire column at Forbes.

California Does Not Need To Sell Health Insurance

It’s taken longer than it should have, but Covered California, California’s Obamacare health insurance exchange, is finally being exposed as a billion-dollar boondoggle.

In 2013, as news about the glitches and scandals in other Obamacare exchanges became impossible to avoid, the New York Times’ Paul Krugman, former Princeton professor and Nobel laureate in economics, went into a defensive crouch around Covered California: “What would happen if we unveiled a program that looked like Obamacare, in a place that looked like America, but with competent project management that produced a working website? Well, your wish is granted.”

Well, not really.

Read the entire op-ed at the Orange County Register.

Obamacare Disguises More Fragmentation of Coverage and Care

Obamacare’s second open-enrollment season has finally closed. After the season was extended a week, the administration reported that 11.7 million people have enrolled. This disguises the massive disruption in coverage and care that people are experiencing.

Read the entire op-ed at the Atlanta Journal-Constitution (by subscription only).

Health Care Added One in Five Jobs In April

45,000 of the 223,000 jobs added in April were in health services, according to today’s Employment Situation Summary from the Bureau of Labor Statistics. This continues the trend seen in March. Jobs in ambulatory settings accounted for well over half of health jobs.

Read the entire entry at NCPA's Health Policy Blog.

Electronic Health Records Don't Help Stroke Victims; And More Bad News

New research on over half a million stroke victims admitted to hospitals from 2007 to 2010 shows that there was no difference in quality of care for those admitted to hospitals with EHRs and those without.

To be sure, this data is from a period just before the federal government mandated hospitals to install EHRs, juiced with $30 billion of payments. Still, it is hard to believe that the government’s artificially accelerating adoption of EHRs that did not do the trick has improved the situation.

This blog has criticized that government program pretty thoroughly. And we are not alone. Over at The Health Care Blog, Margalit Gur-Arie, hardly a right-wing advocate of reducing government’s role in health care, has a scathing indictment of the whole principle upon which the enterprise is based – “interoperability.”

Read the entire entry at NCPA's Health Policy Blog.

Zenefits Raises $500 Million to Reinvent Small-Biz Health Benefits

Most of us buy small-business health benefits the way our grandparents did when they ran the hardware store. It’s a business in dire need of reinventing. Zenefits looks like the company to do it. The company that was one of the top venture deals in health care last year is looking to repeat, raising $500 million at a $4.5 billion valuation.

Read the entire entry at NCPA's Health Policy Blog.

Washington, DC: Rich World's Worst Capital for Infant Mortality

Save the Children has a new report ranking 25 of the world’s richest capital cities by childhood mortality. Washington, DC is the worst. Prague, Stockholm, Oslo, Tokyo, and Lisbon lead.

But I think the international ranking was just to get headlines. The real point of the report is to emphasize differences in infant mortality between rich neighborhoods and poor neighborhoods in these rich capitals.

Read the entire entry at NCPA's Health Policy Blog.

Financing Breakthrough Medicine: Opportunities and Obstacles

Researchers at RAND Corporation have given a clear and precise description of a new financing mechanism for medical breakthroughs. The proposal would address a problem recognized about a year and a half ago, when healthcare payers launched high-profile complaints about the price of Sovaldi®, a miracle drug that effectively cures a strain of Hepatitis C.

In a nutshell, the problem is that Sovaldi® costs up to $84,000 per course, administered over a short period of 12 to 24 weeks. However, its benefits are lifelong: Hepatitis C patients live for decades with diseased livers. Transplantation is a $300,000 procedure followed by expensive drugs to prevent rejection of the new liver. However, payers with annual budgets do not have adequate incentives to pay in one year for savings that accrue over decades.

Read the entire column at Forbes.

Top VC-Backed Health Technology Companies

PitchBook has compiled a roster of 2015’s top venture-capital financed health technology companies.

The three largest valuations are Modernizing Medicine, valued at $316 million, which provides an electronic medical assistant; WellTok, valued at $216 million, which provides personalized guidance on healthy behaviors; and Crosschx, valued at $64 million, which sans patients’ fingers to create a unique, secure identifier.

Pitchbook has also listed the three biggest deals so far this year

Read the entire entry at NCPA's Health Policy Blog.

75 Percent of Emergency Docs Seeing More Patients Since Obamacare

Three quarters of specialists in Emergency Departments are seeing more patients since January 1, 2014, according to a survey released by the American College of Emergency Physicians

Read the entire entry at NCPA's Health Policy Blog.

Americans Say, "Soak the Rich"

After six years of income redistribution, Americans are hungry for more, according to the latest Gallup poll:

Despite the growing focus on inequality in recent years, the 63% of Americans who say that money and wealth should be more evenly distributed among a larger percentage of the people is almost the same as the 60% who said this in 1984.
Americans' agreement that money and wealth need to be more evenly distributed reached a high point of 68% in April 2008, in the last year of the George W. Bush administration, and just before the full effects of the Great Recession began to take hold. Americans became slightly less likely to agree with the idea later that year and in surveys conducted in 2009, 2011 and 2013.

Read the entire entry at NCPA's Health Policy Blog.

Medicare's Pioneer ACO's Ending With A Whimper?

This blog has covered the mediocre and inconclusive results of Medicare’s Pioneer Accountable Care Organization (ACO) model for a couple of years now. A new research paper in JAMA, the Journal of the American Medical Association furthers the narrative that the much ballyhooed program has very slim results

Let’s leave the quality measurements aside for now, and focus on the fiscal effects. There appears to be a small positive effect. However, it appears extremely slim and likely even illusory for a number of reasons

Read the entire entry at NCPA's Health Policy Blog.

Obamacare's Risk Corridors Are Back, And Bigger and Badder Than Ever!

Last December, I discussed with some relief that Congress had stopped the unlimited taxpayer liability of Obamacare’s risk corridors, which protect profits for health insurers by transferring money from insurers with extra profits to those whose profits from Obamacare are less than expected.

The CROmnibus, which funded the government for 2015, put a guardrail around the risk corridors by legislating that any payments beyond budget neutrality would have to be appropriated. (That is, if extra profitable insurers earned $100 “too much” and losing insurers lost $200 “too much”, the winners could pay the losers $100, but the U.S. Treasury could not just make up the balance without Congress appropriating the funds.)

Read the entire entry at NCPA's Health Policy Blog.

Protecting Small Business From the Effects of King v. Burwell

(A version of this Health Alert was submitted as testimony to the hearing, “King v Burwell Supreme Court Case and Congressional Action that can be taken to Protect Small Businesses and Their Employees,” held on April 29, 2015, by the U.S. Senate Committee on Small Business and Entrepreneurship.)

A number of independent sources confirm Obamacare is harming small businesses. According to a paper published by the American Action Forum last September, the increased burden of regulations and rising health insurance premiums have reduced pay in firms with 20 to 99 employees by at least $22.6 billion annually, and has led to 350,000 job losses. Employees who kept their jobs have seen a decrease in pay of just under $1,000 annually.

Read the entire Health Alert at NCPA's Health Policy Blog.

Are Doctors Becoming Democrats?

New research published in JAMA shows that political giving by physicians has swung significantly towards Democrats and away from Republicans in 20 years or so. In 1993-1994, 69 percent of physicians who made political donations gave to Republicans, and their giving comprised 65 percent of doctors’ political giving. In 2013-2014, 45 percent of doctors who made political donations gave to Republicans, and they comprised 50 percent of doctors’ political giving.

Read the entire entry at NCPA's Health Policy Blog.

State Health Insurance Exchanges Going Bust

From the Washington Post:

Nearly half of the 17 insurance marketplaces set up by the states and the District under President Obama’s health law are struggling financially, presenting state officials with an unexpected and serious challenge five years after the passage of the landmark Affordable Care Act.
Many of the online exchanges are wrestling with surging costs, especially for balky technology and expensive customer call centers — and tepid enrollment numbers. To ease the fiscal distress, officials are considering raising fees on insurers, sharing costs with other states and pressing state lawmakers for cash infusions. Some are weighing turning over part or all of their troubled marketplaces to the federal exchange, HealthCare.gov, which now works smoothly.

Well, whether the federal exchange “works smoothly” or not is a discussion for another day. Although, I would beg to differ with the WaPo.

Read the entire entry at NCPA's Health Policy Blog.

Why Don't You Own Your Own Health Data?

David Brailer, MD, was the first head of the Office of the National Coordinator of Health Information Technology (ONC), appointed by President George W. Bush. Today, he is a venture capitalist.

In today’s Wall Street Journal, Dr. Brailer notes that a law passed in 1996 governs our access to health information. Clearly, it needs updating.

Read the entire entry at NCPA's Health Policy Blog.