It looks like Fox News finally felt compelled to acknowledge the most recent CBO report about the Affordable Care Act, but only begrudgingly and with a great deal of spin. After acknowledging that the CBO did predict lower costs connected with the ACA, they rushed to spin it with the "fine print."
The CBO report says lower premium costs are the primary reason for the savings. In the same report, the CBO says that narrower networks and tighter controls on health care usage are part of the reason for the difference.
Here's the language they're focused on:
A crucial factor in the current revision was an analysis of the characteristics of plans offered through the exchanges in 2014. Previously, CBO and JCT had expected that those plans’ characteristics would closely resemble the characteristics of employment-based plans throughout the projection period. However, the plans being offered through the exchanges this year appear to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than employment-based plans do.
However, in the same report on the very next page, CBO says this:
As projected enrollment in exchange plans grows from an average of 6 million in 2014 to 24 million in 2016, CBO and JCT anticipate that many plans will not be able to sustain provider payment rates that are as low or networks that are as narrow as they appear to be in 2014. CBO and JCT expect that exchange plans will still have lower provider payment rates, more limited provider networks, and stricter management of care, on average, than employment-based plans but that the differences between employment-based plans and exchange plans will narrow as exchange enrollment increases.
Yes, it is true that exchange-based plans have limited provider networks and tighter controls on benefits like prescription drugs. However, it is also true that for millions of people who had no access to health care before, those limitations mean nothing. When you go from nothing to something, does it really matter that you get generic drugs?
Furthermore, as Jonathan Cohn observes, part of the problem with our current health care system is the amount of padding in the reimbursement pipeline:
On the other hand, there’s ample evidence that doctors and hospitals routinely overcharge—and, absent price controls, these are the most effective techniques that insurers have for bargaining down prices. In the best of all worlds, insurers would manage care the way innovative group practice organizations, like Intermountain in Utah and the Cleveland Clinic, do. The key, as always, is finding a balance. The Administration recently announced it’d be scrutinizing insurers to make sure their networks of providers are adequate, as the law dictates. It’s also possible that, over time, insurers themselves will loosen controls in order to please customers who want it. CBO, in its report, says it expects that to happen—that, one way or another, insurers will expand networks and relax their management—but not so much that it will cause the law’s cost to skyrocket.
It's long past time for the padding to be squeezed out of the health care system, and that doesn't only apply to insurers. It applies to pharmaceuticals, doctors, hospitals and other providers who build far too large of a margin into what they bill. Insurers haven't cared, because they just pass it on to employers. But in the individual market and with current regulations, that's much more difficult to do.
Still, any way it's spun, they can't take the positive news out of the report, which is that Obamacare will not bankrupt the country nor will it kill Grandma.
