The big news of the week was the release of the Senate health care bill – the “Better Care Reconciliation Act” – on Thursday.
The NYTimes reports:
“The bill, drafted in secret, is likely to come to the Senate floor next week, and could come to a vote after 20 hours of debate…The premise of the bill, repeated almost daily in some form by its chief author, Mr. McConnell, is that ‘Obamacare is collapsing around us, and the American people are desperately searching for relief.'”
Sarah Kliff at Vox.com runs through the contents in a condensed explainer.
“In aggregate, these changes could be advantageous to younger and healthier enrollees who want skimpier (and cheaper) benefit packages. But they could be costly for older and sicker Obamacare enrollees who rely on the law’s current requirements, and would be asked to pay more for less generous coverage.”
Dylan Matthews summarized all of the (many) groups of people who will be worse off if this act becomes law:
“We don’t know for sure how many people will lose health coverage, but there are a number of reasons to think the number will be bigger than the 23 million the Congressional Budget Office estimated would lose insurance under the bill that passed the House in May. The Senate bill cuts Medicaid more slowly but more deeply, and unlike that bill, it lacks any incentive for individuals to stay insured. It repeals the individual mandate and replaces it with nothing.”
Continue reading Health Policy Updates: June 25 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.”
Continue reading Health Policy Updates: June 18 2017
After a couple weeks away for travel, with a LOT that I’ve missed in the interim, here are some of the events and new ideas out over the last week.
First off, the Senate continues to deliberate on health care legislation, with varying degrees of confidence as to whether it will go anywhere. Conservative (though reality-based!) health policy wonks Lanhee Chen and James Capretta have continued to advocate for the incorporation of auto-enrollment into health care reform. This would present a way to “nudge” more healthy people into health insurance – a positive outcome – without the “big-government” personal mandates that Conservatives tend to bristle at.
“Even with the ACA’s penalties for going uninsured, large numbers of Americans are forgoing coverage and either paying additional tax penalties for doing so or applying for an exemption from the law’s individual mandate…If [the AHCA is] enacted, Congressional Budget Office forecasts there would be much lower take-up of insurance under the GOP’s plan than under the ACA…A well-designed automatic enrollment program can help boost enrollment into coverage whatever the design of the overall system.”
Continue reading Health Policy Updates: June 10 2017
There was some buzz this week that the AHCA, as passed by the House, might actually run afoul of Senate budgetary rules that would invalidate the bill. Potentially, this could mean having to revise and re-pass the bill in the House, separately from any process going on in the senate. The potential issues appear to stem from requirements that laws not add to the deficit. I have seen some skepticism that this potential scenario would actually play out; Vox.com offered an explainer.
“Depending on what the CBO says, the House might have to change the American Health Care Act and pass it again or even start over, according to Bloomberg…Experts have wondered if the House bill would work under the Senate’s rules, which are supposed to restrict a bill considered under “budget reconciliation” to make sure it affects only federal spending and revenue. If those strict conditions are met, then the Senate can advance a bill with just 50 votes. Republicans are using that process because otherwise Democrats could block the legislation.”
Continue reading Health Policy Updates: May 20 2017
With the AHCA’s passage of the House, the Senate remains a serious hurdle. Some members have made it clear that the senate will start from scratch, and not base any of their health care reform plans on the House AHCA bill. How this will move forward, and play out in a hypothetical future reconciliation process, is yet to be seen.
“On the Senate side, where several Republicans have long been deeply skeptical of the House effort, the bill is expected to undergo sweeping changes that might leave it unrecognizable — perhaps stripping away some of the provisions that helped earn the support of hard-right House members and ultimately secure its passage.”
Continue reading Health Policy Updates: May 14 2017