Sunday, March 29, 2015

Health Sense: Achievements and pitfalls of Obamacare : Wsj

Health Sense: Achievements and pitfalls of Obamacare : Wsj

Health Sense: Achievements and pitfalls of Obamacare

More than 16 million Americans have gained health insurance as a result of the Affordable Care Act, federal officials say.
But about half of them — the vast majority of those getting insurance on the federal exchange — might drop coverage if a Supreme Court ruling expected by June invalidates government subsidies to help pay for premiums.
Madison-area health care leaders discussed such achievements and pitfalls of the controversial health care law Monday at a panel organized by WisPolitics.com.
The event came on the fifth anniversary of President Barack Obama’s signing of the law, known as Obamacare.
Having more people with insurance is a “good thing for employers,” said Michael Gotzler, chief legal counsel of QTI Group, a Madison-based human resources company.
But offering the coverage can be costly, especially for small companies, Gotzler said. If the Supreme Court bans subsidies in the majority of states that use the federal exchange, including Wisconsin, some firms may stop providing insurance, he said.
That is because the law penalizes employers for not offering coverage only if workers get subsidized insurance on the exchange, he said.
“You may have an economic incentive to drop coverage,” Gotzler said.
More than 207,000 Wisconsin residents signed up for insurance on the exchange, with nearly 185,000 receiving federal subsidies.
Premiums on the exchange mostly have been considered affordable, especially when factoring in the subsidies, but rates could increase in coming years, said Mike Hamerlik, president and CEO of WPS Health Insurance.
That is because two of three financial programs designed to keep costs down for insurers end in two years, Hamerlik said.
“When that goes away in 2017, that revenue is going to have to be replaced by premiums,” he said. “They’re artificially low right now.”
Rick Abrams, CEO of the Wisconsin Medical Society, said doctors are overwhelmed by some aspects of the law, including the requirement that clinics use electronic medical records more.
“The one thing that I wish that we could all do is hit the pause button, maybe hit the slow down button,” Abrams said. “The pace of change is really taking things out of control.”
The Supreme Court ruling could force Congress to tweak the law, Abrams said. “Perhaps it will create an opportunity to fix some of the things that are wrong with the ACA,” he said.
Dr. Jonathan Jaffery, chief population officer at UW Health, said the law’s payment incentives are encouraging hospitals and doctor groups to focus more on the quality of care instead of the volume of it.
But “it is going to take some time until we get to a point where all these things are aligned properly,” Jaffery said.
Hamerlik said the Affordable Care Act may eventually lead to people choosing their own health insurance like they do auto and home insurance.
But that, too, won’t come quickly, he said. “We’re just in the first act of a very long opera,” he said.

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