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
The NYTimes reports on reimbursement practices that leave many seniors and chronic ill people unable to qualify for rehabilitative and home care service, on the premise that they do not have a “rehabable” condition. This leaves many people with long-term and chronic illnesses unable to get coverage for the care they need, and either pay out of pocket or go without. Importantly, this situation continues despite recent policy changes that “improvement” is no longer an appropriate requirement; “maintenance” of current function should theoretically be sufficient to qualify.
“Medicare beneficiaries often hear such rationales for denying coverage of skilled nursing, home health care or outpatient therapy: They’re not improving. They’ve “reached a plateau.” They’re “stable and chronic,” or have achieved “maximum functional capacity.”[…] What matters, as the 2013 settlement of a class-action lawsuit specified, is maintenance. Medicare must cover skilled care and therapy when they are “necessary to maintain the patient’s current condition or prevent or slow further deterioration.”
Continue reading Health Policy Updates: September 17 2016
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
Bernie Sander’s new single-payer health care plan was introduced at the beginning of the week, and Ezra KIein of the left-leaning Vox media was not so keen. Big promises of new benefits, but where exactly was the money to pay for it coming from?
“All in all, Sanders wants to raise taxes by a bit over a trillion dollars per year — which may not sound like much to those who remember the Obamacare debate, but remember that the numbers that got thrown around for Obamacare were 10-year estimates. Adding inflation, Sanders will be raising taxes by close to $15 trillion when the Congressional Budget Office applies its normal scoring window.”
Continue reading Health Policy Updates: January 22 2016