Tag: "Uninsured"

4 to 7 Million Will Be Fined under ObamaCare’s Individual Mandate

From the Congressional Budget Office and the Joint Committee on Taxation:

CBO and JCT estimate that 23 million uninsured people in 2016 will qualify for one or more of those exemptions. Of the remaining 7 million uninsured people, CBO and JCT estimate that some will be granted exemptions from the penalty because of hardship or for other reasons.

All told, CBO and JCT estimate that about 4 million people will pay a penalty because they are uninsured in 2016 (a figure that includes uninsured dependents who have the penalty paid on their behalf). An estimated $4 billion will be collected from those who are uninsured in 2016, and, on average, an estimated $5 billion will be collected per year over the 2017–2024 period.

(CBO, Payments of Penalties for Being Uninsured Under the Affordable Care Act: 2014 Update)

Study: Half a Million More Uninsured by 2019, Four Million More by 2025

A new study by Professor Steve Parente and Professor Michael Ramlet estimates that the number of uninsured will increase under ObamaCare, from 36.5 million in 2015 to 40.5 million in 2025. It further estimates that the average cost of an ObamaCare Silver plan will increase by over $4,000 in five years.

Nationally, we estimate an initial decrease in the uninsured with greater use of the private health insurance subsidies, but over time health plan prices are likely to increase faster than the value of the insurance subsidy. As a result of the declining purchasing power of the insurance subsidy, the implementation of the qualified health plan requirements and the end of the reinsurance and risk corridor programs we estimate a significant reduction in the private insurance market in 2017 with steady declines continuing for the rest of the decade. The Medicaid population is estimated to grow substantially in 2015 as more individuals are enrolled in states who have chosen to expand the program. Medicaid enrollment is estimated to slow down to between 2% to 3% each year from 2016 to 2024.

I guess they had not heard the President’s declaration that the debate over ObamaCare is over.

Should Taxpayers Spend $250,000 to Give an Uninsured Person 16 Days of Healthy Life?

ObamaCare spends a lot of money that could be better spent elsewhere:

money-crossroadsSo, even when we combine the most optimistic estimates of gains in mortality and morbidity, the average uninsured person would gain about 16 healthy days a year…As a comparison, 75-year-olds with foot problems prior to chiropody treatment rate their quality of life at .956. For the average uninsured person, having health insurance coverage provides health benefits that are roughly equivalent to averting the foot problems experienced by typical 75-year-olds.

More importantly, even using the most optimistic assumptions, ObamaCare does not appear to be very cost-effective in relative terms. That is, we could attain the equivalent gains in health status for only 4% of the trillions that will be spent on ObamaCare. Conversely, for the same massive expenditure, we could attain up to 27 times as much improvement in health status. In light of this rather egregious squandering of other people’s money, it’s little surprise that opposition to ObamaCare has been so persistent and widespread.

From: Christopher Conover at Forbes.

Hits and Misses

coins-ira-401kWorkers would rather save up for retirement than pay for health care.

How much do medical graduates earn?

Health Wonk Review is up.

Reducing smoking, drinking alcohol, salt and three other risk factors would save 37 million lives over 15 years.

Survey: 25% of exchange enrollees previously uninsured.

What are the Financial Risks of Being Uninsured?

Previously, Chris Conover showed that the medical risk of being uninsured is small:

…[T]he evidence that having health insurance will reduce mortality risk by any significant amount is pretty thin…even if we assume that having coverage reduces the chance of early death by 22 percent, this is comparable to a half dozen other risks that people face. For the same amount as we are spending to expand coverage under ObamaCare, we could save eight times as many lives by focusing on other causes of death such as smoking.

See also his analysis of the claim that failure to expand Medicaid kills people and Linda Gorman on the same subject at this blog.

In his latest post, Conover shows that the financial risks are small as well:

I have calculated the medical bankruptcy risk facing those with continuous coverage at 1.25 per 1,000. Eliminating this difference would evaporate the risk of medical bankruptcy for 1.89 people out of every 1,000 uninsured Americans every year.

…[I]f having coverage could reduce bankruptcy risk by 1.89/1,000, what would that mean? First, the overall difference in bankruptcy risk (inclusive of medical and non-medical causes) between those with health insurance and those without is 10.7 per 1,000, so eliminating the “excess” risk of medical bankruptcy that we are assuming can be attributed to lack of health insurance coverage would shrink this difference by less than 20%. Perhaps more astonishing, such a reduction would shrink an uninsured person’s overall bankruptcy risk by a mere 11% (from 17.9 to 16.1 per 1,000).

Good News for the Uninsured

Uninsured patients who seek trauma care at a Healthcare Corporation of America hospital will no longer be charged a special trauma fee, which sometimes added as much as $30,000 to their bills…

“Even so, waiving the trauma fees for uninsured HCA patients might have little impact. Hospitals generally collect only a portion of what they bill patients. And the amount collected from uninsured patients — compared to those covered by auto or health insurance policies — can be tiny.”

HCA told the newspaper that their hospitals collect $300 on average from uninsured patients. (More)

Being Uninsured is Better than Being on Medicaid to Get a Doctor’s Appointment

doc-with-patientPosing as patients, researchers made almost 13,000 calls to doctors’ offices in ten states, seeking appointments for a variety of ailments. For those posing as privately insured patients, they got appointments 85 percent of the time. For those posing as patients on Medicaid, they only got appointments 58 percent of the time. Researchers also posed as uninsured patients who were willing to pay in full at the time of the appointment.

The result? 78 percent were successful (for appointments costing more than $75) — 36 percent better than those posing as Medicaid patients and quite close to those posing as privately insured.

What Are the Mortality Risks of Being Uninsured?

This is from Chris Conover:

Since the evidence is equivocal at best, let us — for purposes of discussion — average the point estimates from 4 studies…and compare this relative mortality risk (1.22) to other factors that elevate the annual probability of death.

546

Read More » »

CBO’s Increasing Pessimism

cbouiprojections

Source: Chris Conover at Forbes.

Uninsured Trauma Patients Get Better Care than Insured

Why? Perhaps because non-trauma community hospitals would prefer to have insured rather than uninsured patients. So, uninsured patients are more likely to be transferred to trauma centers, where they are likely to get better care.

According to Kit Delgado, and colleagues, presenting research results in JAMA Surgery, both privately insured and Medicaid patients were significantly more likely (11 percent and 14 percent more) to be admitted to a non-trauma hospital than transferred.

Their conclusion:

Patients with severe injuries initially evaluated at non-trauma center EDs were less likely to be transferred if insured and were at risk of receiving suboptimal trauma care. Efforts in monitoring and optimizing trauma inter-hospital transfers and outcomes at the population level are warranted.