Depending on which exit poll you read, the primary issue that drew the voters to the polling booth was the startling and unprecedented growth of government that has occurred in the last two years. And, while the issue of jobs and the economy were foremost in most voters’ minds, as many as 45% of those polled say it was the health care reform law that tipped the scales for them because it symbolizes the uncontrolled encroachment of government into their lives.

Other polls and surveys are more pointed in their assessment of the public sentiment towards Obamacare.  A pre-election survey conducted by Rasmussen shows that 59% of Americans are in favor of repealing the law.  But, a closer study of the actual election results paints the darkest picture of the electorates disdain for Obamacare and anyone who dared support it.

Voters Cleaned House on Health Reform Mandate

Of course, the Democrats who cast their votes for the health care law took the brunt of voter backlash with nearly 90 losing their House seats and six losing their Senate seats. The lone Republican House member who cast his vote for Obamacare was also defeated.

More telling are some of the results of some of the local elections. The voters in two states, Arizona and Oklahoma passed constitutional amendments that are aimed at stopping the individual mandate from taking effect in those states.  And, with six new Republican governors elected, we can expect the number of states challenging Obamacare in the courts, currently numbering 22, will increase to somewhere near 29.

Obamacare was a defining issue for voters on the opposite side of the issue bringing out those who feel that the new measure needs to be supported and even expanded.  They represent a small minority of voters, approximately 19% who feel the Obamacare is good for America. Another 8% feel that it doesn’t go far enough.

Reading the Voters’ Tea Leaves Regarding Health Insurance

So what can we expect to happen with Obamacare after the voters have spoken?  The Republicans are using the election results to support their contention of a mandate to repeal it. Democrats are spinning the results to their contention that the voter mandate is not to repeal it, rather that they want Congress to work in a cooperative, bipartisan fashion to address the many ills of the country.  With each party controlling one of the houses of Congress, we should count on little in the way of bipartisanship on this issue.

Still, Republicans plan on taking the fight to the House floor by forcing vote after vote on actions to repeal. They’ll get shot down in the Senate, but at least their voices and the voices of at least 59% of the voters will be heard.  They will also chip away the law with attempts to defund specific components that come up for funding. They can also bury certain parts of the bill in committee hearings that could prevent them from seeing the light of day for a long while.

There is a still a lot to be decided in the courts as well, as at least one of the lawsuits brought by the states continues to move forward.  There will more. In the meantime, bits and pieces of the health care reform law continue to take effect. Thus far, there has been little in the way of positive effects that could possibly change the public’s sentiment.  In fact, the more they see, the less they like it.  It’s going to be a very interesting, if not entertaining next 24 months.

photo credit: j_bary

The recent announcement by the federal government that it will require health insurers to seek its approval for any “unreasonable” rate increases continues to put the squeeze on health insurers as they try to adjust their business models to cope with the pressures of Obamacare. While these attempts at health insurance price controls may seem like a good idea to consumers, their net effect could be the erosion of access to medical services that may no longer be covered by insurers.

This latest announcement from the Department of Health and Human Services comes on the heels of its warning to insurers last summer that high premium increases could result in their exclusion from the insurance exchanges. Since the passage of the health care law last December, most major insurers, in direct response to the new law, have increased premiums or proposed plans to do so, some in excess of 35%.

Obamacare: Your Insurance Rates Will Go Down. Really?

These immediate rate increases and predictions of more to come are not the response that the Obama administration wanted to see at a time when it still is trying to convince the public that the health care law will result in lower premiums. Such has not been the case, and all indications are that insurers will continue to press for premium increases as more of the law’s provisions go into effect.

The new requirements will establish a state and federal oversight of insurers rate increase proposals on individual and small group plans that exceed 10%, above which may be deemed as “unreasonable” unless otherwise justified by the insurer. If an insurer demonstrates a pattern of excessive premium increases, the state may exclude it from the insurance exchange. The federal government reserves the right to step in if it determines that the state’s review was not sufficient.

Insurance Rates vs Coverage – Something Has to Give

As the government steps up its oversight and keeps its downward pressure on premium rates, the insurers will be forced to cut their costs, which means the possible elimination of certain covered services and treatments. Within the first 9 months of the law’s enactment, insurers have already dropped maternity coverage, child-only policies, and mental health coverage. For consumers, they may benefit from caps on premium increases; however, their access to medical services may suffer as a result.

The tug of war going on between the insurers and the federal government over insurance premium rates will do little to address the core issue of reigning in medical costs. Rising insurance premium rates are merely a symptom of the much larger, structural problems of the health care system that have resulted in the world’s highest medical costs.

Amidst public outcry about AARP’s recent public support of Health Care Reform, AARP remains confident that the new Law will benefit their members. AARP claims that, of all of the changes listed in the 2,800-page Law, the following ten features stand to benefit AARP and its members the most.

1. Everyone has to have health insurance coverage. Whether it be a public or a private plan, every American is to have coverage of some sort.
2. Preventive health care will be affordable by 2014 when associated copays will be eliminated. Health maintenance is a key component of health care reform.
3. Nobody can lose their coverage because of their medical history or a change in health condition. From children to the elderly, once you have coverage you cannot lose it.
4. Health insurance coverage cannot be capped because the insured has used all of their coverage. Annual or lifetime limits on coverage will be a thing of the past.
5. Pre-existing conditions will no longer determine health insurance eligibility, regardless of the type of condition.
6. Youth under 25 will have the option of maintaining coverage under their parents.
7. Insurance fraud is to be taken seriously and will no longer be ignored.
8. Efficient use of medical resources by medical professionals will be rewarded, while there will be consequences for wasteful use of resources. This should save everyone money in the long run.
9. State health insurance exchanges will allow those who purchase their own health insurance to have more options. Congress, federal employees, retirees, and dependents are all to use this exchange system.
10. The new Health Care law reduces the amount Medicare Part D subscribers have to pay out of pocket for prescriptions. The “Donut Hole” will be countered by a rebate and 50% off brand name drugs.

Image by IowaPolitics.com

In a two-hour-long conference held by the University of California and the Senate Health Committee, health care representatives discussed the best way to go about implementing health care reform in California. While each group offered different solutions and opinions, almost all present agreed that California is perhaps the best place to begin executing the reform.

The two key concerns of the forum were:

• Delivery Systems
• Insurance Market Reforms

Overall, the panelists expressed a lot of enthusiasm mixed in with almost as much anxiety. Of course, health reform is very complex, and every step has to be executed without error in order for reform to succeed. The states taking the lead in health care reform, including California, are under a lot of pressure to succeed.

Health Care Delivery Systems

The health care industry costs more to operate every year. The United States cannot sustain the increase in costs for even another decade. As such, implementing new delivery systems will allow the government to cut costs by up to 30%. In addition to the lower costs, improved delivery system efficiency will allow patients better access to the care they need.

Insurance Market Reforms

As current reform stands, health insurance companies are to begin paying an insurer tax to help fund the reform. Most insurance companies understand the logic but are struggling to understand why self-insured plans are not taxed. There are few incentives in place for insurance companies that offer coverage to anyone signing on to a taxed plan. There are still changes that need to be made in order to make the health insurance market functional by 2014.

California recognizes the importance of health care reform. While the state itself has several weaknesses, including a poor economy and too few public health professionals, they have confidence in their leadership and their public health education system. Making health care reform succeed in less than ideal conditions should set a good example to the states that are in similar situations.

photo credit: Robert Couse-Baker