Saturday, January 31, 2015


I will be skiing until February 10. I have some blog entries scheduled at NCPA and Independent Institute, but will not be cross-posting them here until I return.

Thursday, January 29, 2015

Arkansas: Caving In or Standing Up To Obamacare's Medicaid Expansion?

Almost two years ago, our colleague Linda Gorman was cautiously optimistic about Arkansas attempted Medicaid waiver. Instead of just expanding Medicaid, the state would take the federal funds that Obamacare offered, but use them to subsidize the newly eligible to buy commercial insurance on the Obamacare exchange.

Two years later, a new governor wants to do something a little different. The new governor, Asa Hutchinson, appears to have confused a lot of people in a recent speech about Medicaid, the joint state-federal welfare program for poor people’s health coverage.

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

Wednesday, January 28, 2015

The Congressional Budget Office's Rose-Colored, Short-Sighted View of Obamacare Spending

Obamacare’s spending is going to explode. CBO projects the average exchange subsidy per covered enrollee in 2015 will be $4,330 and increase to $7,710 in 2025, an increase of 78 percent in nominal terms. In real, inflation-adjusted terms it is an increase of 48 percent (using the CBO’s estimate of future Consumer Price Inflation).

And 2025 is only ten years in the future! We have had Medicare for fifty years, and their is little political will to get its unfunded liability under control. Don’t let the CBO’s rose-colored short-sighted vision lull us into complacency: Obamacare is a long-term spending disaster.

Read the entire column at Forbes.

Tuesday, January 27, 2015

Under Obamacare, Will America Keep Winning the War on Cancer?

The American Cancer Society (ACS) has just released its annual Cancer Facts and Figures. The announcement describes how successful the war on cancer has been:
Annual statistics reporting from the American Cancer Society shows the death rate from cancer in the US has fallen 22% from its peak in 1991. This translates to more than 1.5 million deaths from cancer that were avoided.
There are a number of explanations for this success.

Read the entire article at Forbes.

Monday, January 26, 2015

Are Employers Who Dump Workers Onto Medicaid Corporate Welfare Queens?

There have been a lot of predictions about the future of employer-based health benefits under Obamacare. Reports suggest that increasing numbers of small businesses are dropping health benefits and sending their employees to Obamacare’s insurance exchanges, where they are partially subsidized.

Other businesses have found a bigger cost-shifting approach. BeneStream, a new benefits advisor, advises employers how to make their workers dependent on Medicaid, a welfare program fully funded by taxpayers. And businesses are taking advantage of its advice.

So: Are these employers corporate welfare queens?

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

Saturday, January 17, 2015

Hospitals Only Accounted for 15 Percent of 2014 Health Jobs Growth

Last Friday’s employment report demonstrated once again that Obamacare is not having the effect that the health services industry overall hoped for: Employment in health care is increasing at pretty much the same pace as in the rest of the economy. There is no evidence of an Obamacare jobs bump.

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

Obamacare Enrollments Slow To A Trickle

Only 102,000 people enrolled in Obamacare via the federally operated exchange during the week of December 27 – January 2, bringing the total to 6.5 million. This supports my previous expectation that Obamacare enrollment is petering out.

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

Obamacare Increases Emergency Department Use In Los Angeles County

Los Angeles County, Obamacare’s Ground Zero (so described because of the huge number of its residents enrolled in Obamacare’s health insurance exchange) is seeing an influx of patients into hospitals’ emergency departments.

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

Gallup's Easily Misunderstood Health Insurance Survey Is Out

For many months, I have struggled with the Gallup-Healthways survey of health insurance, which I criticized in a previous entry. Of all the surveys of health insurance it is the least informative, and I wish the Gallup folks would give their results better context. Unfortunately, because it is the timeliest, the media get excited about it, especially since Obamacare started.

The latest survey, which covers the 4th quarter of 2014, reported that the “uninsured rake sinks to 12.9 percent”. Just look at the graph: What a nosedive in the number of uninsured Americans! Well, not so fast.

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

FDA Regulation of Mobile Health Apps Is A Real Threat

Do you want the Food and Drug Administration (FDA) to regulate your smartphone? Many in the booming digital health industry are indifferent to the risks of the FDA regulating apps as medical devices. As I noted in a recent Health Alert, the FDA’s current doctrine is to allow most new apps onto the market without regulation. However, this openness is defined only in rules written by the FDA itself, not legislation. Rep. Marsha Blackburn and others in Congress have proposed to amend the law to prevent the FDA from overreaching.

Entrepreneurs and patients who think that the FDA’s current posture is eternal should be aware of a campaign to regulate apps for health. Here’s a recent article from Mother Jones:

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

How To Get A Medicaid Work Requirement? Bundle It With Paul Ryan's Opportunity Grants

Utah Governor Gary Herbert and North Carolina Governor Pat McCrory have asked President Obama to allow them to include work requirements in their Medicaid programs. Work requirements were critical to the success of welfare reform in 1996, and would also change Medicaid from a dependency-trap to a true safety net. The best way to achieve it would be through legislation, not relying on executive action.

According to a new study released by the National Center for Policy Analysis, including Medicaid and the State Children’s Health Insurance Plan (CHIP) as part and parcel of reforming the safety net, instead of keeping health care in its own silo, would greatly improve the federal welfare state for both recipients and taxpayers.

Read the entire column at Forbes.

Digital Health Venture Funding Doubled in 2014

If it hasn’t happened to you already, it will soon: Your doctor, employer, health insurer, friend, or colleague will recommend you try a new smartphone app to keep you healthy. Apps are just one example of the fast growing area of digital health, which refers to applying digital technology that has changed so much of our lives to the healthcare industry.

Two recent reports show how important digital health is becoming, and how fast. StartUp Health, a New York-based accelerator, and Rock Health, a San Francisco-based accelerator and seed fund, have independently reported that funding for new digital health ventures in the United States doubled in 2014.

Read the entire column at Forbes.

Tuesday, January 6, 2015

Obamacare's Effect on the Uninsured Is Trivial

At the end of 2014, Jason Furman and Matt Fiedler of President Obama’s Council of Economic Advisers published an analysis of the uninsured in the first half of 2014. The two economists boasted that “2014 has seen largest coverage gains in four decades, putting the uninsured rate at or near historic lows.”

Their own graph shows how exaggerated and misleading this claim is.

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

Podcast: Explaining the Importance of Ending Obamacare's Risk Corridors

One of NCPA’s successes in health policy last year was to influence the Congress to limit Obamacare’s “risk corridors”. This was the part of the 2010 Affordable Care Act that instituted an unlimited taxpayer liability to protect health insurers from losing money in Obamacare’s exchanges for three years.

Sean Parnell of the Heartland Institute interviewed Senior Fellow John R. Graham about the effect of the lame-duck Congress eliminating this unlimited taxpayer liability.

Listen to the 20-minute podcast here.

Monday, January 5, 2015

A New Year's Resolution: Moving Beyond the Heliocentric Doctrine of Health Insurance

With Republicans in their strongest legislative position since the 1920s, 2015 will likely be a year of significant initiatives on post-Obamacare health reform. As we move into the New Year, let’s make a resolution to keep one reform principle in mind: The United States needs to move beyond the “Heliocentric Doctrine” of health insurance, whereby patients and insurers switch dance partners every January 1.

Read the entire column at The Daily Caller.

Open Enrollment In Obamacare's Second Year: Early Lessons Learned

On November 15, Obamacare’s second enrollment season opened. Applicants who wanted coverage starting on January 1 had to apply by December 15. Now that the New Year is upon is, we can take three early lessons away from the first six weeks of open enrollment:

  1. Obamacare’s enrollment target of 9 million to 10 million for 2015 (reduced from 13 million) is still very optimistic.
  2. Inertia rules: It appears that two-thirds of 2014 enrollees have auto-enrolled in the same plan, although most could have saved on premiums if they had shopped around.
  3. On average, each new 2015 enrollee is receiving a bigger subsidy than the average 2014 enrollee. So, even though there are fewer Obamacare dependents than initially expected, the total cost to taxpayers may not go down.

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

Friday, January 2, 2015

Medicaid Expansion Does Not Create Healthcare Jobs

Ani Turner of the Altarum Institute has examined the growth in healthcare jobs in states which expanded Medicaid versus those which did not expand Medicaid.

Ms. Turner’s entire blog entry is a valuable contribution to the debate over the effect of Medicaid expansion. What I found especially interesting is that healthcare job growth in the 12-months before Medicaid expansion was twice as high in the states that expanded Medicaid (14.500) than those which did not (7,400). This suggests that growth in healthcare jobs causes Medicaid expansion, rather than the other way around.

Medicaid Expansion Does Not Create Healthcare Jobs

"No New Hope" For Risk Corridors

Actuaries at Milliman have published a new report on the consequences of the CROmnibus preventing health insurers from dipping into taxpayers’ funds to finance Obamacare’s risk corridors. The entire seven pages is well worth reading.

Although giving their report the title “No New Hope”, Milliman’s actuaries are not entirely pessimistic about insurers’ ability to get taxpayers’ funds out of the risk corridors. Indeed, they note that the CROmnibus comprises only one piece of an increasingly complicated legislative and regulatory trail.

At NCPA, we think that health insurers which continue to cling bitterly to Obamacare’s promise that taxpayers would bear their business risk are less likely to be prepared to adapt their business models to the health reform that replaces Obamacare shortly after a new President takes office.

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

Thursday, January 1, 2015

We Still Don't Trust the Government to Stop Ebola (Or Do Anything Right)

Remember Ebola? Sure, we still hear about it once in a while, but it doesn’t scare us like did earlier in the year. A few months ago, the media had many of us convinced that America would turn into an Ebola-ridden wasteland. Although no Ebola outbreak has occurred in the United States, most Americans still believe that the public authorities are unable to protect us from this threat, according to previously unpublished research conducted the RIWI Corporation.

Read the entire column at