Viewpoints: Obamacare dilemma -- some people dislike the law but embrace its provisions; are health costs falling?

Apr 16 2014

Los Angeles Times: The Trade-Offs Of Obamacare's Preexisting Condition Coverage
Polls have consistently shown that even though the public opposes Obamacare, people like some of its most significant provisions. That's particularly true of the requirement that insurers ignore preexisting conditions when signing up customers for coverage. Yet that one provision, also known as guaranteed issue, is responsible for trade-offs that people bitterly oppose (Jon Healey, 4/14). 

The Washington Post: Obamacare's Victory Lap
It's all over but the shouting: Obamacare is working. All the naysaying in the world can't drown out mounting evidence that the Affordable Care Act, President Obama's signature domestic achievement, is a real success. Republican candidates running this fall on an anti-Obamacare platform will have to divert voters' attention from the facts, which tell an increasingly positive story (Eugene Robinson, 4/14).

Reuters: America: The Anecdotal Nation
In America today, anecdotes have become the new facts. Consider Obamacare. Opponents have produced ads featuring apparently ordinary Americans telling stories about the travails forced upon them by the Affordable Care Act. One ad, financed by the Koch brothers, highlighted a leukemia sufferer named Julie Boonstra, who claimed that Obamacare had raised the cost of her medications so much that she was faced with death! Pretty dramatic stuff -- except that numerous fact-checkers found she would actually save $1,200 under Obamacare. But what are you going to believe -- a sob story or a raft of statistics about the 7.5 million Americans who have signed up and the paltry 1 million folks who had policies canceled? (Neal Gabler, 4/14).  

The Washington Post: Let HHS Nominee Sylvia Burwell Explain Obamacare Lie
Senate Democrats have been desperately trying to move the national conversation away from Obamacare to just about anything else before the midterm elections -- "paycheck fairness," the minimum wage, even the Koch brothers. But President Obama's choice of Sylvia Burwell to replace Kathleen Sebelius as secretary of Health and Human Services thrusts Obamacare right back into the national spotlight -- and with it Obama's false promise that "if you like your health-care plan, you can keep your health-care plan" (Marc A. Thiessen, 4/14).

Bloomberg: Will Burwell Corral Health-Care Costs?
In the past several months, health-care costs outside Medicare may have accelerated, even as Medicare spending growth remains remarkably low. This is why Sylvia Mathews Burwell (who is a friend of mine) has the opportunity to be a transformational secretary of Health and Human Services. If over the next three years she can take the bold steps needed to reinforce better value in health care, she will drastically alter prospects for everything from the federal budget to state and local priorities (including education) and the take-home pay of America's workers (Peter R. Orszag, 4/14).

Bloomberg: Will Obamacare Actually Cost Us Less?
The Congressional Budget Office just announced that it's revising the projected cost of the Affordable Care Act -- downward. The reason? ... The biggest change is simply that it projects premiums will be lower, which means that it projects the government will pay out less in subsidies. And why does it think premiums will be lower? Because it didn't anticipate what the insurers did: slashing their provider networks to the bone in order to keep premiums low (Megan McArdle, 4/14).

The Washington Post: Congress Must Learn To Pay For Tax Breaks It Extends
Just in time for tax day, the Congressional Budget Office delivered a pleasant surprise. Based on current law, the national debt will grow by $286 billion less during the next decade than the CBO projected only two months ago. The main reason is a downward adjustment in the nonpartisan agency's forecast of subsidy costs for health insurance purchased on the Affordable Care Act's exchanges (4/14).

The San Jose Mercury News: Norma J. Torres: Covered California Needs More Diversity, Expertise
Covered California will be better prepared to address its challenges with customer service and low Latino enrollment if legislative leaders and the governor take much needed action to diversify and broaden the expertise of its board of directors. Although Covered California met and exceeded their expectations for the inaugural enrollment period, enrollment fell short in at least two key target markets -- Latinos and young adults. Whether Covered California has long-term success depends partly on whether it can improve its enrollment numbers for these populations (Norma J. Torres, 4/14).

JAMA Pediatrics: A New Opportunity To Define Health Care Reform For Children
The critical need is sustaining high rates of coverage for children while maintaining affordable access. The hugely popular CHIP program closed the gap of uninsured children but faces an uncertain future unless it is reauthorized in 2015. Some believe the availability of subsidized insurance through exchanges might obviate the need for a separate CHIP program, although early evidence suggests that while benefits are similar to exchange plans, exchange cost sharing may be higher and network access reduced (David M. Rubin and Kathleen Noonan, 4/14).

On other health issues -

The New York Times: Preventing Painkiller Overdoses
The Food and Drug Administration earlier this month approved a hand-held device that can quickly reverse the effects of an overdose and prevent deaths from opioid painkillers and heroin. The easy-to-use injector ... can now be used by family members or emergency responders at the scene of an overdose. ... The announcement was made in part to shift the focus of discussion from the F.D.A.'s controversial decision to approve a prescription painkiller, Zohydro ER, which contains pure hydrocodone and is released over an extended period to relieve chronic pain. An expert panel had advised the F.D.A. against approval until Zohydro ER or others like it could be made more resistant to tampering or abuse (4/14). 

WBUR: Why Zohydro Ban Is A Tough Call
U.S. District Court Judge Rya W. Zobel today disappointed anyone who expected her to quickly strike down Gov. Deval Patrick's ban on the sale of the new pain reliever Zohydro. She declined to rule on the drugmaker's request to quickly but temporarily lift the ban, and is continuing to consider whether to lift the ban permanently. Judge Zobel faces a difficult decision but not because Zohydro, as many media reports have said, is more potent than anything else on the market. It's not, and we'll get to that in a minute (Judy Foreman, 4/14).

The Wall Street Journal: Taking The Powerball Approach To Funding Medical Research
Participants anxiously await the announcement of the winning numbers, thinking to themselves, "Someone has to win, why not me? Just think of what I could do with a million dollars!" But alas, better luck next time. Powerball? Mega Millions? Unfortunately, no -- we are talking about research funding from the National Institutes of Health (Ferric C. Fang and Arturo Casadevall, 4/14). 

The New York Times: Room For Debate: DNA And Insurance, Fate And Risk
As costs for DNA sequencing drop, hundreds of thousands of Americans are undergoing the procedure to see if they are at risk for inherited diseases. But while federal law bars employers and health insurers from seeking the results, insurers can still use them in all but three states when considering applications for life, disability and long-term care coverage (4/15). 

The New England Journal Of Medicine: Therapy For Hepatitis C -- The Costs Of Success
The availability of effective, oral regimens of therapy for hepatitis C will lead to major changes in the management of this disease and probably affect both its morbidity and its mortality. ... Collectively, these regimens promise to transform hepatitis C from a condition requiring complex, unsatisfactory therapies and specialist care to one that can be effectively treated and easily managed by a general physician with few contraindications and side effects. Unfortunately, not all barriers to treatment will be lifted. The major limitation remaining will be economic. The current cost of a 12-week regimen of sofosbuvir alone is $84,000, or $1,000 per tablet. The addition of ledipasvir will add to the costs. ... The predicted costs of the new oral antiviral agents are as breathtaking as their effectiveness (Jay H. Hoofnagle and Averell H. Sherker, 4/12).

The Journal of the American Medical Association: The Changing Legal Climate For Physician Aid In Dying
While once widely rejected as a health care option, physician aid in dying is receiving increased recognition as a response to the suffering of patients at the end of life. With aid in dying, a physician writes a prescription for life-ending medication for an eligible patient. Following the recommendation of the American Public Health Association, the term aid in dying rather than "assisted suicide" is used to describe the practice. In this Viewpoint, we describe the changing legal climate for physician aid in dying occurring in several states (David Orentlicher, Thaddeus Mason Pope and Ben A. Rich, 4/14).

WBUR: Autism: Awareness Helps, But What We Really Need Is Knowledge
April is autism awareness month. Awareness is great. But what really frustrates me and other parents of children with autism isn't a lack of awareness but rather how little is actually known about the disorder (IIlyse Levine-Kanji, 4/14).