The Obama administration has released a report, based on HHS and CBO data and analysis, predicting that PPACA will cause health care premiums to be lower in 2014 than they would have been without reform. We’re happy to see that the report gives a great deal of credit to insurance exchanges as a powerful contributor to the lower projected premiums. Exchanges will help moderate premium growth by giving “…individuals and small businesses pooled purchasing power to get private health insurance at lower premiums.” Exchanges will also “…make it easier and less costly to purchase health insurance, offering clear and standard information on plans to consumers.” And exchanges will bring more competition into the market as well, by offering a level playing field for new private health plans to compete “…based on price, quality, and services offered.”

Our experience running the nation’s largest private Medicare exchange says this analysis is on the right track. For example, we know that many insurance carriers visit our exchange to compare their plans against others and make sure they’re staying competitive; it’s a transparent mechanism where they can see how their plans stack up against others in the same locality. And more than half of our enrollees use our exchange during AEP to evaluate their current coverage and make changes if they feel their premiums have gone up too much, using their power as informed consumers to take charge of their health care benefits.  Competition, transparency, informed consumers: all factors that help keep costs in line on our exchange today, and will do the same thing for exchange users in 2014.

Titled The Public’s Health Care Agenda for the 112th Congress and fielded just before the repeal vote, the latest Kaiser Family Foundation/Harvard School of Public Health poll results are out today.  Unfavorable views on PPACA, which had been dropping in recent months, took a sharp turn upward to 50% (from a low of 40% in November) while favorable views dropped to 41% – with sharp divisions in opinion along party lines.

Paradoxically, many provisions of the reform bill are viewed favorably by a majority of respondents, including reducing payments to Medicare Advantage plans (56% favorable vs. 35% unfavorable), the 50% discount on drugs in the Part D doughnut hole (85% favorable vs. 14% unfavorable) and increasing Medicare premiums for some higher-income seniors (53% favorable vs. 45% unfavorable). Majorities favor provisions that will expand coverage, but are opposed to individual and employer mandates.

Recommended reading, especially the Chartpak.

We surveyed our retiree panel just before the House of Representatives voted to repeal the PPACA, and only a small group of respondents say the bill should stay. We had 386 respondents 65 years and older reply to the survey. A large minority –  42% – support repealing the bill in its entirety. Another 17% of respondents say they are against repeal while 30% favor repealing parts, but not all, of the bill. You can read the press release with full results here.

This post on Steve Ungar’s Forbes blog poses an interesting question: are more small businesses starting to offer health insurance as a result of the Affordable care act? No statistics yet, but some anecdotal evidence from carriers suggests that it’s possible the tax breaks in the bill for small businesses who offer insurance are working as intended.

Our quarterly newsletter, TheExchange, is out today.  This issue includes an interview with Alain Enthoven, professor of economics at Stanford University.  Professor Enthoven has been at the heart of the issue of health care reform in this country for many decades; he was the first person to propose consumer-choice health care concepts that later developed into the exchanges in the PPACA. In his interview he gives his first-person perspective on the history of health care reform over the last few decades, and timely advice on three things Congress ought to do as they debate repeal of the legislation. Here’s one thing he recommends: Read the rest of this entry »