Healthcare Thursday

Health reform has little effect on projected spending, huge impact on coverage … Americans will spend almost $4.6 trillion on healthcare in 2019 — a 77 increase above current levels, the Obama administration projected Thursday.

Yet as a share of the economy, the figure, representing 19.6 percent of gross domestic product (GDP), is a modest increase above pre-health reform projections, which put 2019 health spending at 19.3 percent of GDP — without gaining coverage for tens of millions of uninsured Americans.

The estimates, crunched by economists at the Centers for Medicare and Medicaid Services (CMS), contain ammunition for both sides in the thorny debate over the Democrats' new health reform law. 

For instance, the numbers represent an average spending increase of 6.3 percent each year over the next decade — or 0.2 percent more than CMS had projected just before the reforms were passed. That's sure to energize critics of the law (Republican lawmakers), who have said all along that it wouldn't rein in the skyrocketing growth of healthcare costs.

On the flip side, CMS projects the increase in health spending between 2015 and 2019 will average less than the agency had estimated before the law was enacted. That is, after implementation of the 2014 coverage expansion — the central component of the bill estimated to provide health insurance to 32.5 million people previously without — CMS expects spending growth to be slower than pre-reform rates.

That's sure to prod Democratic health reform supporters to tap the new estimates as evidence that the law is working as advertised. Nancy-Ann DeParle, head of health reform at the White House, issued a statement Thursday saying the numbers "suggest that for average Americans, the Affordable Care Act will live up to its promise."

The new projections — which are nearly identical to those crunched by Medicare's actuaries in April — were published Thursday by the journal Health Affairs.

Six days and counting: Lawmakers are on the last legs of their summer vacation, and GOP leaders are preparing their flock for the 1099 debate they'll face immediately upon the return to Washington. The office of Senate Minority Leader Mitch McConnell (R-Ky.) sent out talking points to colleagues this week, referring to the new tax filing requirement — a $17 billion revenue generator contained in the new health reform law — as "a paperwork Pandora's box." 

Republicans, according to the memo, should highlight the number of businesses affected by the provision (estimated at 40 million); argue the new paperwork will hobble companies ("A Nebraska small business estimates the mandate will cost $23,000/year"); and warn the new $600 purchasing threshold will cause businesses to consolidate their suppliers, "in which case smaller suppliers would lose out."

Sen. Mike Johanns (R-Neb.) has proposed a full repeal of the filing requirement, while Sen. Bill Nelson (D-Fla.) has offered an alternative that would scale it back.

The Republicans intend to argue that Nelson's version picks "winners and losers with thousands of businesses still subject to the job-killing mandate."  

A cloture vote on the Johann's bill is scheduled for next Tuesday, and the Senate is expected to move to the Nelson bill immediately afterward.

Unveiling last year's health coverage numbers: The Census Bureau on Thursday, Sept. 16, will release new figures outlining poverty, income and health coverage trends in 2009. In response, the Center on Budget and Policy Priorities will host a conference call with reporters later in the day.

A weighty cost issue: The gap between health costs for obese Americans and those of normal weight has grown enormously during the past two decades, the Congressional Budget Office (CBO) reported Wednesday. In 1987, obese Americans cost an average of 8 percent more to treat; in 2007, the figure was 38 percent. 

The yawning gap, CBO says, "probably" has a number of causes, "including changes in the average health status of the obese population and technological advances that offer new, costly treatments for conditions that are particularly common among obese individuals." http://bit.ly/cbVHBq

Conservatives launch ad campaign attacking health reform supporters: Revere America (yes, that Revere) launched a seven-figure ad campaign Wednesday targeting vulnerable Democrats who voted in favor of healthcare reform. The conservative group hasn't named its dozen-or-so targets, but says the ads will begin airing later this month. http://bit.ly/cwTuu3

A liberal group plans a counter-attack: The Health Information Campaign plans to spend $2 million on ads touting the benefits of the health reform law. The first spot focuses on the insurance reforms set to take effect Sept. 23. http://bit.ly/ckZKfl

Florida docs versus the AMA, cont'd: The Florida Medical Association (FMA) on Tuesday officially aired its problems with its national counterpart, the American Medical Association, sending a letter reiterating FMA's "serious reservations about the AMA’s effectiveness and its ability to represent the physicians’ interests." The letter followed last month's FMA decision not to drop out of AMA, but to send a message of no confidence instead. http://bit.ly/bYDxJz

This post was updated at 11:00 a.m. Thursday.