Tuesday Short Cuts

Remember that University of Michigan study I posted about last week which claimed that in spite of all the predictions by ACA opponents that expanding Medicaid would make it impossible for enrollees to actually make a doctor's appointment, the opposite ended up being the case?

A new University of Michigan study shows that the availability of primary care appointments actually improved for people with Medicaid in the first months after the state launched the Healthy Michigan Plan, the state’s Medicaid expansion under the ACA. What’s more, it remained mostly unchanged for those with private insurance.

Well, apparently the Michigan results are not an outlier:

Since the implementation of Obamacare picked up in the fall of 2013, Americans are reporting better health and easier access to doctors, a new study found. But minority Americans as well as lower-income Americans reported even greater gains.

“The reduction in the uninsured rate among Latino adults was greater than the reduction among white adults,” the study noted, with Latinos reporting a reduction at 11.9 percent compared to 6.1 percent reduction among non-Latino whites. Likewise, non-Latino blacks saw a greater drop in the uninsured rate than whites, reporting a 10.9 percent reduction. In the areas of access to doctors and medicine, Latinos and blacks also made greater gains than their white counterparts.

More "big-picture" good news for healthcare costs which, again, somehow just happen to coincide with the passing of the Affordable Care Act:

The price of health care has grown more slowly than core consumer prices—what Americans spend on everything except food and energy—over the past five years. It’s the first time that’s happened since record-keeping started in 1959. That’s a remarkable break from decades of health-care prices outpacing inflation, but consumers shouldering a greater share of their medical costs may not notice the difference.

More bad news for ACA-enabled CO-OPs, however, I'm afraid:

Louisiana Health Cooperative, the state's not-for-profit health plan created through the Affordable Care Act, will close by year-end. It's the second co-op casualty in less than a year, and a sign that many other co-ops are on life support.

Louisiana's plan suffered from high-cost medical claims and low enrollment in the state's insurance exchange. The ACA created the consumer-governed co-op option to inject competition into the individual market. But the plans have faced steep operating challenges, including sicker-than-average memberships, slashed federal funding and less name recognition than larger carriers. 

This article from the AP about the continuing problems that many state-based exchanges are experiencing (both technical and funding-wise) has gotten a lot of play the past few days, but I'm not sure why; with King v. Burwell out of the way, there's an easy out for any state which decides to bail on their exchange: Move to HealthCare.Gov:

State-run health insurance markets that offer coverage under President Barack Obama's health law are struggling with high costs and disappointing enrollment. These challenges could lead more of them to turn over operations to the federal government or join forces with other states.

Hawaii's marketplace, the latest cautionary tale, was awarded $205 million in federal startup grants. It has spent about $139 million and enrolled 8,200 customers for individual coverage in 2015. Unable to sustain itself, the state marketplace is turning over sign-ups to the federal HealthCare.gov for 2016.

Twelve states and the District of Columbia fully control their markets. Experts estimate about half face financial difficulties. Federal taxpayers invested nearly $5 billion in startup grants to the states, expecting that state markets would become self-sustaining. Most of the federal money has been spent, and states have to face the consequences.

For all the concern about security issues at Healthcare.Gov and other government websites (and yes, it's certainly something which should be taken seriously), the "private sector does it better" myth is just that...a myth:

Following close on the heels of the massive data breach at health insurer Anthem, the parade of hackings at major health care providers continues with the recent announcement of a data breach at UCLA Health System affecting 4.5 million people. The hacking appears to have gone on undetected since September of 2014 until its recent discovery. The compromised information is a treasure trove of personal data for identity thieves. It included names, Social Security numbers, medical records, ID numbers and addresses. But, as I always say, things aren't as bad as you think – they are far worse. The stolen data was totally unencrypted making the threat to the people whose data was in the UCLA Health Systems computers more serious.

...With the health care industry accounting for 42.5% of all data breaches over the last three years, considerably more than any other sector of the economy, according to the Identity Theft Resource Center and 91% of all health care organizations reporting at least one data breach over the last two years, the question for consumers seems to be less how do we prevent ourselves from becoming a victim of medical identity theft and more what can we do to limit the damage?