posted April 10, 2014 09:54 PM            

Before we get to these studies, though, we should recognize why we need outside organizations to validate White House claims in the first place. The Department of Health and Human Services still has no way to quantify important data about those consumers signing up for health insurance through state and federal exchanges.

More than six months after the initial rollout of Obamacare -- and four years after the ACA’s passage -- the systems designed by HHS still cannot determine basic and critical information about enrollments such as whether a premium payment has been made. Without a premium payment, a sign-up in the web portal does not mean coverage has been extended.

Furthermore, the systems were not designed to collect important demographic information such as pre-existing coverage, current health status, or even definite age ranges, even though the success of the Obamacare structure depends on getting previously uninsured healthy Americans locked into expensive comprehensive insurance.

Without the “young invincibles” providing new funding for risk pools that now have to cover older and less-healthy consumers under “community pricing” restrictions, premiums will escalate rapidly, forcing more consumers out of the system and triggering the dreaded “death spiral” for insurers.

In order to determine the scope of the celebration, then, we need outside surveys to give us an idea of the size and composition of the actual enrollment population in Obamacare. The first of the independent studies comes from the RAND Corporation, which studied the changes in the health insurance market between September 2013 – just before the rollout of the state exchanges – and the end of the open-enrollment period at the end of last month.

While the White House can claim credit for a net increase of 9.3 million insured and a lowered uninsured rate from 20.5 percent to 15.8 percent, the data provides a significantly different picture than that painted by President Obama and the ACA’s advocates.

First, a significant amount of this increase comes from Medicaid enrollments, not private insurance. Almost six million people enrolled in Medicaid, and earlier studies showed that a relatively small number of those came from the expansion built into the ACA; most of these would have been Medicaid-eligible prior to the reform.

Another 8.2 million more people enrolled in employer-provided health care, as 7.1 million left the “other” category and another 1.6 million left the individual insurance markets. Only 3.9 million actually enrolled in insurance plans through state or federal exchanges – not 7.1 million as claimed by Obama. That number falls far short of even the lowered expectations issued by HHS and the White House earlier this year.

Moreover, those who did enroll through the state exchanges didn’t provide the demographic lift and risk-pool support needed to prevent massive increases in either premiums or deductibles, or both, in the near future. Pharmacy benefit manager Express Scripts, which collected more data from insurers than HHS managed through its own exchanges, determined that the incoming enrollees require more medical attention than the previous risk pools, not less – which means that insurers will need to raise premiums even more than first thought.

Their new study shows, for instance, that the enrollees from state and federal exchanges have a 47 percent higher use of specialty medications than in commercial plans in general. “Increased volume for higher cost specialty drugs can have a significant impact on the cost burden for both plan sponsors and patients,” the report reminds readers. “Despite comprising less than 1 percent of all U.S. prescriptions,” the report continues, “specialty medications now account for more than a quarter of the country’s total pharmacy spend.”

The medications themselves show that the care costs will increase relative to the existing risk pools as well. The rate for HIV medications in Obamacare exchange plans is four times higher than in existing commercial plans. Medication prescriptions are 35 percent higher, and anti-seizure medication increases 27 percent. Ironically, the only category where exchange consumers have lower demand than commercial-plan customers is in contraception – the focus of a big political battle in the employer mandate.

As Express Scripts, which studied changes in pharmacy benefits concludes that the ACA has succeeded in getting coverage to consumers who need it. However, that comes at a high cost for those who had their existing coverage canceled and saw their premiums and deductibles skyrocket as a result of Obamacare. Furthermore, the number of those who gained coverage may be even smaller than the RAND study concluded.

Of those who enrolled in an exchange plan, Express Scripts finds, 43 percent already had Express Scripts coverage in 2013 – and at least some of the other 57 percent may have had coverage under another prescription-medication management service. If the total number of actual exchange enrollees is 3.9 million, the final number of previously uninsured exchange consumers may be only as high as 2.23 million.

posted April 11, 2014 07:56 AM            

"First, a significant amount of this increase comes from Medicaid enrollments, not private insurance. Almost six million people enrolled in Medicaid, and earlier studies showed that a relatively small number of those came from the expansion built into the ACA; most of these would have been Medicaid-eligible prior to the reform."

"Only 3.9 million actually enrolled in insurance plans through state or federal exchanges – not 7.1 million as claimed by Obama."

posted April 11, 2014 10:07 AM            

The Heritage Foundation has published a series of 15 charts that it aptly titles, “The Charts Obama Doesn't Want You to See,” telling the story of Obamacare in at-a-glance style. Here are two samples.

For your leftist friends who can't be bothered to read, these shold prove useful.

posted April 11, 2014 11:01 AM            

O'BomberCare was never about health insurance or health care. It's always been about government control of 16% of the US economy.

posted April 11, 2014 11:46 PM            

Wrong!

HillaryCare sank beneath the waves with barely a ripple. Now, those demoscats who lied to their constitutents..."you can keep your doctor if you like your doctor" and "you can keep your insurance plan if you like your insurance plan" and..."the average family will save $2,500 per year in insurance premiums"...well, they're getting ready to sink beneath the waves too.

posted April 17, 2014 08:32 AM            

Welcome to the O'BomberCare scam.

Brain Surgery Patient's Obamacare Plan Denies Meds, Drops Doctors
Wynton Hall
16 Apr 2014

A New York woman suffering from a neurological disease that has required four brain surgeries has been dropped by all of her doctors and denied medications due to her Obamacare plan.

"I've been vomiting. I lost 22 pounds. The pain is unbearable," said Margaret Figueroa, 49, on Wednesday. "My medication helps me function during the day."

Figueroa suffers from a disease known as Arnold Chiari Malformation and Syringomyelia. Even though the Obamacare plan she purchased assured her that she was covered, her insurance card was denied when she went to fill her prescriptions. Then she learned that none of her doctors accept her Obamacare plan. Figueroa says she cannot find a doctor who accepts her Obamacare plan; indeed, there are only six doctors in all of Staten Island who take her plan, none of whom she's been able to get appointments with.

Figueroa's congressman, Rep. Michael Grimm (R-NY), intervened to help her obtain some of her vital prescriptions. Grimm says he's already received calls from at least a dozen Staten Island residents facing the same problem with Obamacare's "narrow networks" – extreme restrictions to doctor and hospital access imposed by Obamacare.

"Even though the insurance company cashed your check, it doesn't mean it (the policy) has been implemented," said Grimm at a Wednesday press conference with Figueroa. "That's the problem – that the back end of Obamacare hasn't been fully built. You can go on the front end of an application and look at a list of plans, but what they don't tell you is that many of those plans don't have doctors yet."

Figueroa is not alone.

As Breitbart News reported in January, the Washington Post warned that "Obamacare's narrow networks are going to make people furious – but they might control costs." Breitbart News contributor Scot Vorse learned the hard way about Obamacare's narrow networks when the nearest dentist who accepted the mandatory dental plan he was required to purchase for his children was over 100 miles away.

Obamacare's narrow networks have also shut out access to top cancer centers. The Associated Press says just 4 of 19 nationally recognized comprehensive cancer centers offer Obamacare access through all insurance plans in their state Obamacare exchanges, and a McKinsey and Co. study revealed 38% of all Obamacare plans only allow patients to pick from just 30% of the largest 20 hospitals in their areas.

Experts say the narrow network horror stories will only grow as more and more Obamacare customers attempt to use their Obamacare insurance only to realize its harsh realities.