With the reconciliation tax bill headed towards passage, it looks like the individual mandate may be done for.
In the lead-up, I had heard conflicting reports of how the repeal of the individual mandate would affect the rest of Obamacare going forward – everything from “meh” to “instant death spiral.” A couple of resources to get a handle on where we are at:
- Julie Rovner’s “What the Health” podcast at Kaiser focused on mandate repeal this week.
- Sarah Kliff addressed the question in a recent article.
“Economists roundly expect premiums to rise if the individual mandate disappears, as healthier people exit the market, leaving behind a sicker, more expensive insurance pool. Some Americans may gladly exit the marketplace, happy to no longer pay insurance premiums. But there would also be those who exit unwillingly, people who want to buy coverage but cannot afford the rising cost of health insurance.”
Continue reading Health Policy Updates: December 16 2017
Health care spending continues to increase – the rate of increase in 2016 was 4.3%, down from 5.8% in 2015 but still greater than inflation. Health care now takes up 17.9% of the US economy. The out-of-pocket costs borne by patients, though, are up more sharply.
“A shift toward insurance plans that transfer more of the burden of health care costs onto patients helped fuel the rise in out-of-pocket costs. In 2016, 29 percent of people who receive insurance through employers were enrolled in high-deductible plans, up from 20 percent in 2014. The size of the deductibles also increased over this time period, a 12 percent increase in 2016 for individual plans, compared with a 7 percent increase in 2014.”
Continue reading Health Policy Updates: December 10 2017
It has not been a good week for US health care.
This week the Senate passed “a health care bill disguised as a tax cut.” The result, argues Sarah Kliff, will be a sweeping change to many parts of the US health care system, starting with (per the CBO) 13 million Americans dropping health insurance coverage.
“First, the bill repeals the individual mandate, a key piece of Obamacare that requires most Americans get covered. Economists expect its elimination to reduce enrollment in both the Affordable Care Act’s private marketplaces and Medicaid by millions. The money saved will be pumped into tax cuts for the very wealthy. The bill also includes tax cuts so large that they would trigger across-the-board spending cuts — including billions for Medicare. The last time Medicare was hit with cuts like this, patients lost access to critical services like chemotherapy treatment.”
Continue reading Health Policy Updates: December 3, 2017
New data from the Kaiser Family Foundation on prescription drug spending in Medicare. I found the out-of-pocket cost burden to be particularly notable – over $3,000 on average for patients hitting the catastrophic threshold, which will include most cancer patients.
A couple of pieces this week analyzing what the White House could do (if it truly wanted) to lower drug prices. This comes in the wake of the nomination of Azar, a former pharmaceutical executive, for HHS secretary.
The first, from three separate, feasible policy strategies that could lower prices:
“Finally, Trump and Azar could bring the pharmaceutical industry to the negotiating table for excessively priced essential drugs covered by government payers such as Medicare and Medicaid. Current law allows federal programs to seek competitive bids for patented medicines, even if they come from companies other than the patent holder.”
The second describes and analyzes the actions that White House has already taken to start to address drug prices:
“Several health policy experts noted that although the new policies spare pharmaceutical companies any direct intervention, they are aimed at fixing real market distortions and are grounded in evidence. They may also reflect the levers the government can easily pull without legislative action.”
Just when you thought Obamacare repeal was over, it’s back – this time, as part of the GOP tax reform effort.
“The revised Senate tax bill will repeal the individual mandate, according to multiple reports. Repealing the mandate — which is the gear that makes the Affordable Care Act tick — would save more than $300 billion over 10 years, but only because millions fewer Americans would have health insurance, according to the Congressional Budget Office. It also means higher premiums, because the younger, healthier people who have an incentive to buy insurance rather than pay the mandate would be expected to exit the market while the sicker people stay in.”
Continue reading Health Policy Updates: November 19 2017