GOP will try to tack Obamacare repeal to tax reform, which would cause millions to lose health care

The following article by Emily C. Singer was posted on the website November 14, 2017:

Republicans just can’t quit their unpopular effort to repeal the Affordable Care Act.

After multiple failed efforts to repeal former President Barack Obama’s signature health care bill, Republicans announced on Tuesday they will try to tack a repeal of the individual mandate — a key pillar of the health care law — onto the GOP tax reform bill.

Repealing the individual mandate — which was part of the “skinny repeal” effort that failed in the Senate over the summer — would free up funds that Republicans could use to pay for their tax cuts. Read More

Senate GOP changes tax bill to add Obamacare mandate repeal, make individual income cuts expire

The following article by Mike DeBonis and Damian Paletta was posted on the Washington Post website November 14, 2017:

Senate Majority Leader Mitch McConnell (R-Ky) said on Nov. 14, he was “optimistic” about adding the individual mandate repeal to the tax bill. (The Washington Post)

Senate Republican leaders moved Tuesday to include a repeal of the Affordable Care Act’s individual mandate in their tax bill, a major change of strategy as they try to accomplish two of their top domestic priorities in a single piece of legislation.

They also announced that the individual tax cuts in the plan would be made temporary, expiring at the end of 2025 to comply with Senate rules limiting the impact of legislation on the long-term deficit. A corporate tax cut, reducing the rate from 35 to 20 percent, would be left permanent. Read More

ObamaCare becomes political weapon for Democrats

The following article by Peter Sullivan was posted on the Hill website November 10, 2017:

© Greg Nash

ObamaCare is emerging as a top issue for Democrats as they seek to gain control of Congress in next year’s midterm elections.

Just a year after worries about ObamaCare premiums were seen as a contributing factor in Hillary Clinton‘s loss, voter concerns about GOP attacks on the health-care law seem to be bolstering Democratic candidates.

Health care was by far the number one issue in Virginia, where Democrats won races up and down the ballot on Tuesday night with a surprisingly strong showing. Exit polls showed that 39 percent of voters ranked health care as their top issue, with 77 percent of those voters backing Democrat Ralph Northam for governor. Read More

ACA sign-ups spike at open enrollment’s start

The following article by Juliet Eilperin and Colby Itkowitz was posted on the Washington Post website November 7, 2017:

This post has been updated.


The number of consumers signing up for plans under the Affordable Care Act has surged during the first few days of open enrollment compared with past years, according to federal and state officials.

More than 200,000 Americans chose a plan on Nov. 1, the day open enrollment began, according to one Trump administration official. That’s more than double the number of consumers who signed up on the first day of enrollment last year. More than 1 million people visited, the official federal website, the official said, amounting to roughly a 33 percent increase in traffic compared with 2016. Read More

When Silver Costs More Than Gold: How Trump’s Actions Have Scrambled Insurance Prices

The following article by Margot Sanger-Katz and Kevin Quealy was posted on the New York Times website October 27, 2017:

The rates for next year’s Obamacare plans are out, and they show how President Trump’s actions have scrambled the insurance marketplace.

Usually, plans known as gold have higher monthly premiums but lower out-of-pocket costs than “silver” plans, which have tended to cost less each month and have been the most popular plans.

But this month, Mr. Trump carried out a longstanding threat and ended certain subsidies for insurers. To compensate for the lost funding, insurers increased the prices of their plans — heavily in the silver category and less so in others. Read More

President Trump’s false claim that insurance companies ‘have made a fortune’ from Obamacare

The following article by Glenn Kessler was posted on the Washington Post website October 19, 2017:

The president misleadingly correlates insurance company’s rising stock prices to profits related to Obamacare, but they are not one in the same. (Meg Kelly/The Washington Post)

“We want the money to go to the people. We don’t want the money to go into the pockets. I have a list here where it talks about the insurance companies. … Anthem, big company, from the beginning of Obamacare, 270 percent increase in their stock price. Humana, 420 percent up. Aetna, 470 percent increase from Obamacare. Cigna, 480 percent increase since Obamacare. The insurance companies have absolutely taken advantage of this country and our people. And I stopped it by stopping the CSRs.”
— President Trump, responding to a question from Mike Sacks of E.W. Scripps, Oct. 17, 2017

“I don’t want to make the insurance companies rich. If you look at their stock price over the last number of years — take a look at what’s happened with those insurance companies — they’re making a fortune by getting that kind of money.”
— Trump, remarks on the White House lawn, Oct. 13, 2017 Read More

Trump’s not going to be able to avoid blame for kneecapping Obamacare

The following article by Philip Bump was posted on the Washington Post website October 13, 2017:

President Trump on October 4, 2017. (Mandel Ngan/AFP/Getty Images)

This article has been updated.

Let’s set aside for the moment President Trump’s decision to end Obamacare’s cost-sharing reduction payments (CSRs) to insurers, a system under which insurers are subsidized to help keep costs low for low-income insurance recipients.

Let’s also set aside the other ways in which the Trump administration has been deliberately undermining enrollment in the Obamacare marketplaces. We’ll set aside that the administration has slashed funding to outreach programs by as much as 92 percent, ended partnerships with state groups aimed at getting people enrolled, cut funding for advertising the enrollment period and even decided it would shut down the enrollment website for 12 hours a week for maintenance. Read More

Why Trump’s executive order may compound the health insurance industry’s problems

The following article by Profession J.B. Silvers was posted on the Conversation website October 13, 2017:

Credit: REUTERS/Kevin Lamarque

President Donald Trump has issued the first of what promises to be a series of health insurance executive orders aimed at dismantling the Affordable Care Act.

It instructs the government to essentially exempt small businesses and potentially individuals from some of the rules underpinning the landmark legislation known as “Obamacare,” following the GOP’s failureto get Congress to approve a plan to repeal and replace it.

These steps would free more employers to access bare-bones and short-term health insurance coverage and join together to bargain with insurers. It’s not clear how this order will change the U.S. health insurance market. But as a health finance professor and the former CEO of an insurance company, I’m confident it is more likely to compound many of Obamacare’s problems than to fix them.

Designed this way

To be sure, the Affordable Care Act has problems. For example, premiums have continued to rise since the Affordable Care Act’s enactment – albeit at a moderate pace for insurance obtained through employment.

In particular, many smaller employers have seen their costs rise dramatically since insurers were forced to price their plans based on the average of all claims in the small group market rather than the experience of each firm.

But there is a reason why Obamacare was designed this way. Employers with older and less healthy workers were almost shut out of the insurance market because insurers deemed them so costly to cover and wanted to avoid the risk. Companies with younger and healthier workers had a good deal previously, but many other employers did not.

The Affordable Care Act was supposed to solve this problem by lumping everyone together to even out rates. Making rates more reasonable for many Americans meant requiring some of us to pay more.

Market dynamics

The government’s attempt to keep President Barack Obama’s oft-repeated promise that “if you like your current plan, you can keep it” didn’t help. Employers with low-cost plans and healthier workforces chose to be grandfathered out of many new requirements, leaving a much less healthy – and more expensive to cover – pool for pricing everyone else’s insurance.

Nevertheless, the share of adults without health insurance fell to a record low of 10.9 percent in late 2016, from 18 percent before the health insurance exchanges opened in October 2013, as measured by polling by Gallup and Sharecare. (The uninsurance rate has ticked up to 11.7 percent since Trump took office.)

What would be a good way to get the remaining 28 million Americansinsured at a reasonable cost? It may seem obvious that letting small businesses without much purchasing power in the health insurance market band together will enable them to get the same deals as large self-insured companies – which get to choose among a variety of options.

In most markets, this kind of diversity and choice fosters the robust competition Trump says he wants to see. But in health insurance, this may lead to fragmentation and market failure.

That’s because as insurers scramble for ideal customers – those least likely to get sick – they drive higher-risk people away by charging them higher premiums and making them foot a bigger share of their medical bills. Unfortunately, the latter (people often with preexisting conditions and requiring long-term treatment) really need medical care and the insurance coverage required to get it.

Because of this, all but the largest of the association health plans that the executive order is supposed to encourage still will most likely exclude high-risk individuals and employers, just as they have in the past, as health law expert Tim Jost predicts.

How will the vulnerable get health care?

Trump said that his executive order will help “millions and millions of people.” But I believe it is more likely to drive coverage for many out of reach while benefiting the Americans whose insurance needs are relatively minimal.

One could argue that the government should never have tried to force healthier people to pay so much more for coverage to make it affordable for everyone else. Yet the nation needs a mechanism to help Americans with chronic and preexisting conditions pay for the medical care they need.

Pres. Trump says he’s signing executive order to provide millions of Americans with Obamacare relief; will cost gov’t “virtually nothing.”

Establishing high-risk pools is one way to make this work, and they definitely can help as long as there is funding available. Unfortunately, most attempts to handle high-risk individuals this way have run out of money and left vulnerable patients high and dry. Trump’s approach does nothing to deal with this.

Any solution that makes health insurance more affordable across the board will need to be comprehensive. I believe Trump is instead embarking on a process that is both naïve and piecemeal based on wishful thinking regarding the power of markets to resolve all the problems with this difficult sector.

During his signing ceremony, he promised that the policies established by the order would “cost the government virtually nothing.” If that proves true, it is likely that we will receive exactly what we pay for.

View the post here.

Contraceptive Coverage Under the Affordable Care Act

The following article by Jamila Taylor and Nikita Mhatre was posted on the Center for American Progress website October 6, 2017:

Over the past several months, the Trump-Pence administration, as well as Congress, have attacked women’s health and rights numerous times. Greater access to affordable and effective contraception has been one of the hallmark achievements of the Affordable Care Act (ACA). But now, the current administration is threatening to limit these gains with the release of sweeping regulations that would allow any employer, insurance plan, school, or individual to use the guise of religious or moral objection to deny access to no-cost contraception.

By requiring coverage for contraceptives with no out-of-pocket costs, the ACA increased women’s access to a wide range of contraceptives. Read More

Five things to know about the new ObamaCare repeal bill

The following article by Rachel Roubein and Nathaniel Weixel was posted on the Hill website September 20, 2017:

The new ObamaCare repeal bill under consideration in the Senate includes some controversial policies that have divided Republicans in the past.

Some senators haven’t taken a position on the bill from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), saying that they have yet to fully digest the bill and how it would work.

In short: The bill ends federal funds for ObamaCare’s Medicaid expansion and the subsidies that help people afford coverage. Instead, the money would be converted into block grants and given to the states.

Here are five things to know about the legislation. Read More