Health Policy Updates: June 18 2017

The more serious Republicans get about repealing Obamacare, the more insurance companies feel at risk in continuing to offer exchange plans. And the more insurance companies pull out of the exchanges, the worse Obamacare looks and the clearer the rationale for repeal. Are we in a spiral is actually leading towards the ACA’s repeal?

“Meanwhile, across the nation, health insurance plans are beginning to flee the Obamacare marketplace. They’ve cited the uncertainty around the health care law’s future, sown by congressional Republicans and the Trump administration. The number of counties with zero health plans signed up to sell 2018 coverage keeps growing. The possibility that Republicans will repeal Obamacare or drive it into collapse is an increasingly real one. That’s a reality where millions fewer have health insurance and lower-income Americans struggle to afford coverage.”

The Senate looks to capitalize on this instability, hoping to quickly passing a bill that no one has had a chance to read.

“Just as in the House, we’re on track to have a vote with no hearings (there were more than 100 for the ACA). Knowing the coverage loss will be significant, McConnell plans to vote within only days, or possibly even hours, of the release of the CBO score. Moving fast leaves opponents, and the public, with no time to catch up to the details.”

Apparently, the senators themselves haven’t had a chance to read the bill, either. No one knows what is in it, or – even more concerningly – what problems the bill is trying to fix in the first place.

“How will Republicans lower premiums? ‘It’s working together and coming up with a bill that does do that,’ Sen. John Boozman of Arkansas said…What new policy will lead tax cuts to lower premiums? ‘It’s teetering because the exchanges are failing,’ Sen. Roger Wicker of Mississippi explained.”

If you haven’t heard of Andy Slavitt (author of the above op-ed), here is a primer. He ran CMS for 2 years under Obama, and since then has rapidly become something of a health policy rock star, in as much as such a thing could exist. He has recently been campaigning around the country arguing against ACA repeal.

“Slavitt, 50, insists that he is not an advocate or an activist — “If the Republicans came out with a good bill, I would be out here actually supporting it,” he said — but he has become one of the strongest voices in the fight against the dismantling of the Affordable Care Act. He’s also become a kind of amplifier, turned up high enough to create feedback: It can seem as though every story he hears on the town hall trail is broadcast back to a national audience through his daily barrage of tweets, which in turn generate the sharing of more stories, the asking of more questions.”

Nevada is one signature away from passing an interesting new health care initiative, which would allow any state resident to buy into Medicaid coverage. This idea has come to be called “sprinkle care,” after the state representative who has championed it.

“Nevada’s bill to allow a broader Medicaid buy-in is short, running just four pages. It would allow any state resident who lacks health insurance coverage to buy into the state Medicaid program, which would sell under the name the Nevada Care Plan.”



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