Health Care Industry

Democratic politicians condemned Pfizer Inc's tax-avoiding "inversion" deal with Ireland's Allergan Plc on Monday, bringing another round of Washington hand-wringing over corporate taxes, but probably no immediate legislative action. Hillary Clinton, the front-runner for the Democratic presidential nomination, blasted Pfizer for using legal loopholes to avoid paying its "fair share" of U.S. income taxes in a deal she said "will leave U.S. taxpayers holding the bag."

Economists believe something that on its face sounds absolutely bizarre to a normal human being: Obamacare's tax on expensive health insurance will give Americans a pay raise. Here's the argument: Economic theory predicts that companies have a set amount they're willing to pay a worker, given her specific talents and skills. Under this theory, companies are agnostic to whether they spend that money on a salary, a health plan, maybe a gym subsidy, or even a free puppy. What's important is attracting the best workers, and companies will use that money however is necessary in order to get those workers and keep them happy.

IN 1996 the state of Utah put John Albert Taylor, a man who had raped and murdered an 11-year-old girl, to death by firing squad. Chris Zimmerman, a retired police officer who investigated the murder, witnessed the execution. “Off to our left was Mr Taylor, off to the right, behind a wall, was the firing squad,” he remembers. “There was a countdown, and the firing squad were ordered to aim and fire. I heard a simultaneous explosion—you couldn’t tell the guns apart. He clenched his fists, his chest rose a little, like it was suddenly filled with gas. Then he unclenched his fists, the doctor walked out with a stethoscope and checked his pulse, and it was over.”

More than 16 million Americans gained health coverage because of the Affordable Care Act, mainly via the law's health insurance exchange and Medicaid expansion, according to an analysis published Monday by the Department of Health and Human Services. The government estimate is consistent with numerous surveys taken over the past two years. The Health and Human Services report issued Monday is based in part on findings from the polling company Gallup, which found the uninsured rate has fallen from 20.3 percent in October 2013, when Obamacare sign-ups began, to 12.3 percent during the first quarter of this year.

Here's some good news: the latest report from the CBO has reduced its estimate of the cost of Obamacare. This is due partly to a slight decrease in the number of people CBO expects to be covered, but mostly due a lower estimate of the cost of insurance premiums. Thanks to this, federal subsidies are estimated at $209 billion less over a ten-year period, and the cost of CHIP and Medicaid is estimated at $73 billion less. However, there are also reductions in expected revenues from Obamacare's excise tax, so the net reduction amounts to $142 billion over ten years. The table below tells the story. Sarah Kliff has more details here.

One of the first things House Republicans plan to do after Congress reconvenes Tuesday is vote on a bill that would gut Obamacare—and could deprive up to 1.5 million Americans of their employer-sponsored health insurance. After the GOP-controlled House passes the bill, the newly Republican Senate is likely to pass the measure too. What's more, President Barack Obama may be forced to sign this legislation if it is attached to a must-pass budget bill later this year.

Politically, Obamacare has had a terrible past few weeks. First there was inaccurate enrollment data (the administration wrongly included dental plans). Then there were Jon Gruber's comments on "the stupidity of American voters." And it was capped off with Sen. Chuck Schumer saying that passing the law was a mistake. That led to headlines like: "Dark days ahead for Obamacare," "The Obamacare controversy grows" and my own "Obamacare's terrible, horrible, no good very bad month."

Obamacare has had a rough month: it’s being challenged in a Supreme Court case; House Republicans are trying to undermine it with a lawsuit; and its poll numbers are terrible. But on the ground the Affordable Care Act—which is starting its second open-enrollment period—looks robust. Most people in the program say they’re happy with their plans, and new insurers are entering the market. Prices are pretty good, too: estimates suggest that premiums for the second-cheapest of the “silver” plans, which is the benchmark used to set subsidies, have risen by an average of just two to five per cent. Still, one fundamental challenge remains: if Obamacare is to succeed in holding down premiums over the long run, it needs consumers to shop around.