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
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
There were a couple of great articles in JAMA Internal Medicine this week on cancer drug development and pricing.
The first, discussed in this NYTimes article, did a thorough job of tallying the total R&D cost to bring a new cancer drug to market. The study authors ended up with a significantly lower number than has been reported in the past.
“Following approval, the 10 drugs together brought in $67 billion, the researchers also concluded — a more than sevenfold return on investment. Nine out of 10 companies made money, but revenues varied enormously. One drug had not yet earned back its development costs.”
Continue reading Health Policy Updates: September 16 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
Wow, another incredibly hectic week. Health policy has never been so frenzied…even though we ought to be getting used to it by now.
To sum up the horse-trading, by Monday night enough Senate Republicans had come out against the Better Care Reconciliation Act that it became clear the bill would never pass. Senate Leader Mitch McConnell, followed by Donald Trump, quickly reverted to the old “repeal and delay” strategy of voting to repeal the ACA in two years time, giving a prolonged interval to work on replacement. This strategy already failed back in February. Again, enough Senate Republicans came out against “repeal and delay” by Tuesday that this, too, seemed unlikely.
“But it became quickly apparent that GOP leaders, who were caught off guard by defections of their members Monday night, lacked the votes to abolish parts of the 2010 law outright. Three centrist Republican senators — Susan Collins (Maine), Shelley Moore Capito (W.Va.) and Lisa Murkowski (Alaska) — all said they would oppose any vote to proceed with an immediate repeal of the law.”
(the repeal and delay strategy, by the way, would result in 32 million Americans losing insurance, according to the CBO report that came out Wednesday).
Despite what looks like a lack of sufficient vote and the continually-damning CBO scores, GOP leadership continues to plan for a vote next week.
Continue reading Health Policy Updates: July 23 2017