Tuesday Short Cuts: Part I

Ye Olde In-Box is crammed full again, so here goes...

But a new study casts doubt on that theory and suggests Obamacare’s bet may indeed pay off. The study, published in Health Affairs by John Romley, Dana Goldman and Neeraj Sood, found that hospitals’ productivity has grown more rapidly in recent years than in prior ones. Hospitals are providing better care at a faster rate than growth in the payments they receive from Medicare, according to the study.

A new healthcare reform debate may be on the horizon. Democrats refer to the issue at hand as the nation's "underinsured" population, reported the Associated Press.

The Affordable Care Act made it possible for millions of Americans to obtain health insurance, but the ACA plans fail to address the problem of underinsured consumers with substantial out-of-pocket costs, FierceHealthPayer previously reported. For this group, the AP said, out-of-pocket costs add up to 10 percent or more of household income, in most cases, or a deductible amounts to 5 percent of income or higher, according to the Commonwealth Fund's definition.

On Jan. 1, 2016, state employees who still have jobs — the ones who survive budget cuts and the ones who aren’t caught supporting peer-reviewed science — will begin the year with a pay cut.

Of course, it isn’t called a pay cut. It’s called increasing employees’ out-of-pocket health care costs. But additional co-pays and deductibles mean less money for employees — it is a pay cut.

It might be more useful to look at the legislative logic: Will Republicans in Congress believe their constituents will demand a solution if Obamacare starts to disappear.

If so, Republicans will attempt to find one. And they will rapidly discover that the only fix they can deliver -- that they can pass and that the president will sign -- is a patch that restores subsidies until 2017. They might be able to add a little window-dressing to it make it appear as though they are changing the Affordable Care Act, but the president would veto anything significant.

While it is still too early to reach conclusive assessments of the labor market impact of the ACA, the evidence to date looks promising. Republican opponents of Obamacare have often complained that the program would turn the country into a "part-time nation." It turns out that there is something to their story, but probably not what they intended. The number of people who are working part-time for economic reasons, meaning they would work full-time if a full-time position was available, has fallen by almost 16 percent from the start of 2013 to the start of 2015. This is part of the general improvement in the labor market over this period.

The joint study from the Urban Institute and the Robert Wood Johnson Foundation says minimum requirements in the Affordable Care Act that mandate how much insurers must spend on medical care resulted in savings of $5 billion for consumers in 2011 and 2012, the first two full years after Obamacare was enacted in March 2010.

Further, the new spending requirements forced few, if any, insurers out of business, said Lisa Clemans-Cope, a senior researcher for the Urban Institute and one of the study’s authors.

If you have Medi-Cal, chances are you get your health care for free — until you die, that is.

Since 1993, Medi-Cal — California’s version of the federal Medicaid program — has sought repayment of many medical costs, primarily those incurred after age 55. It’s called the Estate Recovery Program, and under Obamacare, it just got bigger and its reach broader.

How broad? Well, your family might face a posthumous bill even if you didn’t seek medical care while you were a Medi-Cal enrollee.

Nearly 40 states chose to continue offering plans that were noncompliant with the Affordable Care Act in 2014, in both the individual and small group markets, according to information CMS recently provided issuers on the one-time, state-based adjustment to the risk corridor calculations. The adjustments were designed to help mitigate expenses attributable to the administration's November 2013 decision that allowed states to let issuers continue offering non-ACA-compliant plans.