Vox.com runs down the recent Trump executive order on health care:
“The ultimate impact will depend on any new regulations written as a result of the order, but overall, the Trump administration could make cheaper plans with skimpier benefits more available — and experts worry that will damage the ACA’s marketplaces.”
More on the White House’s efforts to undermine Obamacare in absence of a Congressional repeal bill:
“But Trump administration officials say that with insurance premiums soaring in many states, consumers should be able to buy less comprehensive, less expensive coverage as an alternative to conventional plans…That has some insurance experts worried. The influx of a set of plans exempt from the Affordable Care Act rules will essentially divide the market and make it increasingly unstable, said Rebecca Owen, a health research actuary with the Society of Actuaries.”
The NYTimes is keeping track of all the ways the White House has been sabotaging the health care law.
Continue reading Health Policy Updates: October 15 2017
This week, reports surfaced to confirm that the Trump administration is actively engaged in ACA sabotage. The strategy is to quite literally inflict financial harm on the American people, by way of increasing insurance premiums on the exchanges.
“For months, officials in Republican-controlled Iowa had sought federal permission to revitalize their ailing health-insurance marketplace. Then President Trump read about the request in a newspaper story and called the federal director weighing the application. “
As long as Trump is out to sabotage things, how about women’s health and rights?
“The new rules take effect immediately. And they allow large, publicly traded companies to seek an exemption from the birth control requirement if they have a religious or moral objection to providing such coverage. The Obama administration barred these large businesses from such exemptions.”
Continue reading Health Policy Updates: October 8 2017
Another frantic news week in health care policy, with the demise of both the Graham-Cassidy Obamacare repeal bill, and of Tom Price’s tenure as HHS secretary.
With passage of Graham-Cassidy looking doubtful, a revised draft of the bill was crafted over last the weekend. This version not-so-subtly moved additional funds to those states with “hold out” GOP senators; this move suggesting something of a vote-buying effort:
“The favoring of certain states over others in the new version of the bill, presumably to please Senators representing the favored states and obtain their votes, raises serious constitutional issues. Law Professor Brian Galle has argued that it would violate the Constitution’s Uniformity Clause, which prohibits laws specifically favoring particular states.”
The overall structure of the bill, including steep Medicaid cuts and a return of pre-existing condition exclusion, remained intact:
“Like the earlier version, the latest draft allows states that obtain block grants to waive certain consumer protections contained in the ACA…As with the earlier draft, however, the consumer protections that the bill does allow states to permit insurers to waive makes protection for people with preexisting conditions very tenuous.”
Continue reading Health Policy Updates: September 30 2017
The September issue of Health Affairs was a special edition, focusing on the topic of health care market concentration in the US. I’ve pointed to the closely related issue of hospital consolidation as one of the biggest drivers of increasing health care costs.
As one of the featured studies in this special issue found, the health care market in the US continues to concentrate, with more and more health systems merging into larger and larger networks. The end result of this is not more efficient care for the patient, but simply higher prices, as these large networks exert their monopoly power:
“Although provider concentration could produce efficiencies that benefit purchasers of health care services, the evidence does not point in that direction. For example, reviews of studies of hospital markets have found that concentrated markets are associated with higher hospital prices, with price increases often exceeding 20 percent when mergers occur in such markets. Of even greater concern, the reviews found that these price increases did not appear to improve quality: In some cases, higher hospital concentration was associated with higher mortality rates.”
Continue reading Health Policy Updates: September 9 2017
The Atlantic on the ongoing efforts in the Senate to pass a bipartisan “improvement bill” to stabilize Obamacare insurance exchanges:
“The hearings are the brainchild of Senator Lamar Alexander of Tennessee, the Republican chairman of the Health, Education, Labor, and Pensions Committee, who has been talking for months about the need to stabilize Obamacare’s individual insurance market…Alexander, aides said, has an ambitious goal of moving quickly from hearings to drafting legislation that would, at minimum, guarantee the continued payment of cost-sharing reduction subsidies to insurance companies and allow states more flexibility to adjust insurance rules…”
Continue reading Health Policy Updates: September 2 2017