Healthcare

Estimating health insurance coverage with little understanding of subsidies

This is for all the fans of government run everything. The following press release from the Department of Health and Human Services relates a study estimating the number of people gaining health insurance, including Medicaid, in the last several months. In fact, the greatest gains were in Medicaid, a change that did not require The Affordable Care Act.

It’s a good thing more people have health insurance. However, wouldn’t you think the government would know the exact number of people who enrolled, especially since most are getting tax subsidies? The government has Social Security records, tax records, enrollment data and who knows what other information on Americans. We talk about better coordination in health care and push for electronic medical records and the people doing the pushing can’t get their own records straight.

On a related matter a General Accounting Office audit found significant problems in the process used to verify eligibility for Obamacare and the tax subsidies. SEE BELOW THE FOLLOWING PRESS RELEASE

FOR IMMEDIATE RELEASE
July 23, 2014
Contact: HHS Press Office
(202) 690-6343

New Study: 10.3 million gained health coverage during the Marketplace’s first annual open enrollment period

Health and Human Services Secretary Sylvia M. Burwell announced today the release of a new study, published in the New England Journal of Medicine, estimating that 10.3 million uninsured adults gained health care coverage following the first open enrollment period in the Health Insurance Marketplace. The report examines trends in insurance before and after the open enrollment period and finds greater gains among those states that expanded their Medicaid programs under the Affordable Care Act.

“We are committed to providing every American with access to quality, affordable health services and this study reaffirms that the Affordable Care Act has set us on a path toward achieving that goal,” said Secretary Burwell. “This study also reaffirms that expanding Medicaid under the Affordable Care Act is important for coverage, as well as a good deal for states. To date, 26 states plus D.C. have moved forward with Medicaid expansion. We’re hopeful remaining states will come on board and we look forward to working closely with them.”

According to the authors’ findings, the uninsured rate for adults ages 18 to 64 fell from 21 percent in September 2013 to 16.3 percent in April 2014. After taking into account economic factors and pre-existing trends, this corresponded to a 5.2 percentage-point change, or 10.3 million adults gaining coverage. The decline in the uninsured was significant for all age, race/ethnicity, and gender groups, with the largest changes occurring among Latinos, blacks, and adults ages 18-34 – groups the Administration targeted for outreach during open enrollment.

Coverage gains were concentrated among low-income adults in states expanding Medicaid and among individuals in the income range eligible for Marketplace subsidies. The study finds a 5.1 percentage point reduction in the uninsured rate associated with Medicaid expansion, while in states that have not expanded their Medicaid programs, the change in the uninsured rate among low-income adult populations was not statistically significant.

Today’s study also looks at access to care, and finds that within the first six months of gaining coverage, more adults (approximately 4.4 million) reported having a personal doctor and fewer (approximately 5.3 million) experienced difficulties paying for medical care.

Today’s study does not include data from before 2012, as coverage was changing rapidly during this period. This means the results do not include the more than 3 million young adults who gained health insurance coverage through their parents’ plans.

The analysis builds on previous studies by reviewing a larger sample size and taking into account changes in the economy and pre-existing trends in insurance coverage. Using survey data from the Gallup-Healthways Well-Being Index for January 1, 2012, through June 30, 2014, the authors analyzed changes in the uninsured rate over time. This is also the first study to associate reductions in the uninsured rate with state-level statistics on enrollment in the Marketplaces and Medicaid under the Affordable Care Act, as described in HHS enrollment reports, and to assess the impact of the improved coverage on access to care.

To read the article visit: http://www.nejm.org/doi/full/10.1056/NEJMsr1406753

As reported by the Associated Press via ABC News

Undercover investigators using fake identities were able to secure taxpayer-subsidized health insurance under President Barack Obama’s health care law, congressional investigators said Wednesday.

The weak link seemed to be call centers that handled applications for frazzled consumers unable to get through online.

The nonpartisan Government Accountability Office told a House committee that its investigators were able to get subsidized health care under fake names in 11 out of 18 attempts — even after HealthCare.gov’s much maligned online system flagged some applications as problematic.

The GAO is still paying premiums for the policies, even as the Obama administration attempts to verify phony documentation.

Those follow-up verification checks also appeared to need tightening; the GAO said parts of the fake documentation it submitted for two applications actually got through the process.

Nonetheless, GAO audits and investigations chief Seto Bagdoyan told the House Ways and Means Committee that the agency has not drawn any sweeping conclusions from what he called its “preliminary” findings. A full assessment will take several months.

In the real world, it may be difficult for fraud artists to profit from the nation’s newest social program, since government health care subsidies are paid directly to insurance companies.

Now the above paragraph is a left leaning interpretation not found in other publications reporting this story. In the real world even if the subsidy goes to the insurance company, the insured certainly does benefit because their premium is reduced each month. In addition, the subsidy does not have to go to the insurance, it can also be claimed at year end by the taxpayer, but of course, they pay a higher premium during the year. Either way fraud artists profit from taxpayer money they are not entitled to.

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