The individual mandate – viewed by many as an essential component of the ACA/Obamacare in order to maintain insurance market stability – was officially repealed this week with the passage of the GOP tax bill. Health Affairs has compiled a list of resources discussing the possible implications of mandate repeal.
According to health policy expert Timothy Jost:
“The CBO, in its most recent analysis of the individual mandate repeal proposal, projected that repeal would result in four million more uninsured by 2019, 13 million more by 2027. Repeal would increase premiums in the individual market by 10 percent or more in most years…But the repeal of the individual mandate penalty will not by any means bring an end to the ACA. The numbers who lose coverage will likely be much smaller than the CBO estimates.”
Continue reading Health Policy Updates: December 23 2017
As of Tuesday, the Senate voted to open debate on a bill which, 24 hours prior, its members did not know the contents of.
“…there are at least four different draft health care bills floating around right now…The lack of clarity is part of a larger lack of direction for Senate Republicans’ six-month health care effort…Throughout this process, Republicans have struggled to articulate what exactly they want to achieve — aside from delivering on a seven-year campaign promise to repeal and replace Obamacare.”
Votes on the BCRA and then “full” Obamacare repeal followed shortly thereafter, and were both defeated by slim margins. Attention then turned to the so-called “skinny repeal,” which would leave the ACA/Obamacare’s Medicaid expansion intact and get rid of only the individual and employer mandates to have health insurance. Finally, even skinny repeal went down in a vote early Friday morning, with John McCain breaking party ranks (and joining Sens. Collins and Murkowski) to become the decisive “no” vote, in a dramatic fashion on the Senate floor – video here.
It remains to be seen whether the ACA repeal effort is truly dead this time, or will continue to rise from its own ashes.
Continue reading Health Policy Updates: July 29 2017
The GOP has finalized a new version of the AHCA, with the goal of getting enough votes from the party membership to ensure passage. The broad structure of the bill appears to remain largely unchanged.
“The GOP’s new proposal would allow states to opt out of many of Obamacare’s requirements, allowing health plans to charge people more based on their age and health status. States could also opt out of enforcing a 30 percent surcharge imposed on people who don’t maintain insurance coverage, which was part of the original GOP proposal, according to a brief update sent to Energy and Commerce members. That’s the policy that the Republicans would use to replace the Obamacare individual mandate…In exchange, states would have to set up a high-risk pool where older, sicker people could buy coverage, likely at much higher prices.”
Apparently, the most-conservative Freedom Caucus members are now starting to support the bill. However, the delay of the proposed House vote yesterday likely means that sufficient GOP support still isn’t there.
Continue reading Health Policy Updates: April 29 2017
An new public health paper in Health Affairs this week compared the effects of social health spending vs. medical spending on outcomes for several common illnesses such as heart attack and diabetes. The results add credence to the view that the social determinants of health may be more important than the medical system in keeping people health.
“We found that states with a higher ratio of social to health spending (calculated as the sum of social service spending and public health spending divided by the sum of Medicare spending and Medicaid spending) had significantly better subsequent health outcomes…”
Continue reading Health Policy Updates: May 28 2016
From Margot Sanger-Katz in the New York Times, on why moving to single-payer health care would be unlikely to “fix” the United States’ health care cost problem. Summary: even if you were to cut out our (significant) administrative costs, such a program would still cost more to run than in other countries because the underlying price of health care is so much higher here.
“That Medicare-for-all plan would still cost more than single-payer plans in other countries. Here’s why: Medicare pays doctors and hospitals higher prices than single-payer systems do in other countries.” Continue reading Health Policy Updates: May 21 2016