What’s New in Health Care Reform: Dec. 9

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What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.


Uninsured People Eligible For Obamacare Face Average $969 Penalty in 2016

The penalty for failing to have health insurance is going up, perhaps even higher than you expected. Among uninsured individuals who are not exempt from the Affordable Care Act penalty, the average household fine for not having insurance in 2015 will be $661, rising to $969 per household in 2016, according to a Kaiser Family Foundation analysis. Individuals will pay the penalty when they complete their federal taxes the following spring. Via Kaiser Health News.

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Lawmakers Press ObamaCare Chief on State Money Troubles

Lawmakers pressed a top ObamaCare official about the possibility of more financial problems at state-run marketplaces under the law, after some have been plagued with problems. A House Energy and Commerce subcommittee questioned Andy Slavitt, the acting administrator of the Centers for Medicare and Medicaid Services (CMS), about the 13 states that run their own insurance marketplaces under ObamaCare, rather than using the federal one. Via The Hill. 

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Rankings: More States Improve Than Worsen on Most Health Measures

More states improved than worsened over time on most measures examined in new health rankings out — the first since the Affordable Care Act’s coverage expansions took effect. The Commonwealth Fund Scorecard on State Health System Performance looks at access to medical care, prevention and treatment of disease, avoidable hospital use and cost, healthy lives, and health equity. Some of the 42 indicators on the scorecard are numbers of insured adults, people 50 and older who got recommended screenings, adults who went without care because of cost, breast cancer deaths, and infant mortality. Via USA Today.

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Health Tax Delays Hinge on Broader ‘Extenders’ Deal

Several health-related taxes could be part of a broader package of tax “extenders” that is being worked out among lawmakers, according to lobbyists and Capitol Hill aides close to the negotiations. The provisions could include the a two-year delay on the medical device tax and the Cadillac tax on high-cost employer-provided insurance, as well as a one-year delay on a health tax to insurers. Via Morning Consult.


CBO Expects Reduction in Workers Thanks to ACA

The Congressional Budget Office estimates that the country’s labor supply will be 0.86 percent smaller in 2025 than it would have been without the Affordable Care Act. The full-time equivalent workforce will be about 2 million smaller than it is now, it says. The office released a working paper that says the labor supply will be reduced 0.8 percent by 2019, before rising to 0.86 percent, according to its projections of how people and businesses will respond to changes under the health law. Via Morning Consult.


Health Spending in U.S. Topped $3 Trillion Last Year

Health spending in the United States last year topped $3 trillion — an average of $9,500 a person — as five years of exceptionally slow growth gave way to the Affordable Care Act’s expansion of Medicaid and private insurance coverage, and as prescription drug prices resumed their sharp climbs, the government said. Health spending grew faster than the economy in 2014, and the federal share of health spending grew even faster, as major provisions of the Affordable Care Act took effect. Via NY Times.

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Why Some Would Rather Pay The Obamacare Penalty Than Buy Insurance

Those without health in­sur­ance have a lot to con­sider. On one hand, the fine for re­main­ing un­in­sured steeply in­creases for next year. On the oth­er, the cost of the in­di­vidu­al man­date pen­alty is cheap­er than buy­ing the least ex­pens­ive in­sur­ance plan for 7.1 mil­lion of the nearly 11 mil­lion un­in­sured eli­gible to en­roll in health ex­changes, ac­cord­ing to a Kais­er Fam­ily Found­a­tion ana­lys­is. Via National Journal.

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Improving Health And Health Care: An Agenda For Reform

The debate over, and eventual enactment of, the Affordable Care Act (ACA) brought to the surface of American politics a long-standing divide over the proper orientation of health care policy. On one side are those who tend to promote more federal control and government regulation over insurance markets and the organizations delivering services to patients. On the other side are those who are more inclined to support consumer incentives and market mechanisms to improve the value and quality of patient care. Of course, there is overlap in the kinds of policies advanced by the two sides in this debate, but the underlying philosophical disagreement is deep and makes reaching broad-based consensus difficult. Via Health Affairs.

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Health Care Reform - Departments Issue Final Rules Under ACA

Last month, the Departments of the Treasury, Labor and Health and Human Services issued final regulations governing several market reforms implemented under the Affordable Care Act. These regulations finalize the 2010 interim final regulations and amendments without substantial change and incorporate the guidance and clarifications issued by the departments since 2010. Via The National Law Review.

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Health Care Innovation Doesn’t Have to Be Driven by Profit

As health care reform evolves, large public institutions that offer a health safety net have some advantages over privately owned enterprises. That may sound counterintuitive, but it’s true. For many years, private-sector providers and other business interests have responded to a combination of patients’ actual needs and market opportunities while trying to optimize earnings. When the type and amount of health services largely depend on independent providers’ discretion, care becomes more fragmented and costly. But large, publicly supported safety-net institutions are driven less by external payers and market forces, and more by patient and community needs — and clinicians often participate prominently in decision making. Those are all assets in an era of health care reform. Via Harvard Business Review.

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Kelley Schreiber

Kelley Schreiber is a Marketing Channel Manager at Mayo Medical Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her new kitten, and exploring new foods.