The Alexander-Murray bill, a bipartisan compromise to try to stabilize the Obamacare insurance markets, already faced some big hurdles, such as ambiguous support from the White House. This week, an alternative “stabilization” bill emerged, this one entirely Republican, which seems to look a little bit more like Obamacare repeal than simply an insurance market patch.
“Hatch-Brady adds explicitly partisan objectives that Democrats will likely reject: the cuts to the Obamacare mandates and the introduction of anti-abortion restrictions to the CSR payments…Hatch and Brady have now introduced two of the most divisive issues in health policy — the individual mandate and abortion — to the Obamacare stabilization talks. Their plan is more akin to a slightly skinnier version of ‘skinny repeal’ from the summer than an Obamacare stabilization package that both parties would likely support.”
Continue reading Health Policy Updates: October 28 2017
Donald Trump garnered some eye-rolls from health policy experts when he stated last week that “nobody knew healthcare could be so complicated,” in relation to why repealing and replacing Obamacare has been taking longer than he initially estimated.
Because, of course, everyone who takes healthcare seriously already knew that.
More from the NYTimes:
“And no governor was ready to say publicly that he or she could accept a replacement health law covering fewer people than the Affordable Care Act, which has extended coverage to 20 million Americans. A bill drafted by House Republicans could cover fewer people. It would roll back the heath law’s expansion of Medicaid…”
Continue reading Health Policy Updates: March 4 2017
The big policy news from this last week was that the Center for Medicare and Medicaid Services (CMS) released the so-called “final rule” on the Medicare Access and CHIP Reauthorization Act of 2015, also known as MACRA.
What is MACRA, you ask? And what is a “final rule”? Well, you may remember intermittent debates, fights, and panics a few years ago about the Sustainable Growth Rate, and Medicare reimbursement formula that always threatened to drastically cut doctors’ pay under Medicare, except for the fact that Congress kept “temporarily” delaying it for years. MACRA is the replacement – no huge cuts to doctors’ pay immediately, but it does put into place a new regime of cost-controlling strategies linked to holding physicians accountable to a range of quality-of-care measures. The final rule finalized, ahem, the exact cadre of payment incentives, deductions, and implementation time frames that constitute MACRA. Health Affairs summarizes here.
“As an initial sign they hit the target, key Members of Congress have already weighed in applauding the Rule. Here’s a tip: when Members applaud a regulation like this so quickly, two things are going on: 1) they are taking a solid helping of credit for changes the agency has made; and 2) they are putting affected stakeholders on notice that they have an uphill battle in securing new changes soon. Read: this is as good as it’s going to get.”
Continue reading Health Policy Updates: October 22 2016
A large part of the ACA/Obamacare was to expand Medicaid; many (though not all) states elected to do so. New data out this week in JAMA Internal Medicine suggests that patients are benefiting. Compared to states that did not expand Medicaid, previously uninsured patients who have now gained access to Medicaid coverage do better on many metrics, including better access to outpatient care, increased diabetes screening, and reduced non-compliance due to cost.
The Oregon Medicaid experiment from a few years ago left Medicaid skeptics with some reason to be agnostic as to whether Medicaid actually improves people’s health. These data lessen the foundation for such skepticism, and should thus should help move the conversation forward. Continue reading Health Policy Updates: August 14 2016
One of the parts of the ACA/Obamacare law was the creation of insurance companies known as “coops.” These consumer-run organizations were intended to increase competition and offer lower-cost insurance options to patients. However, many of the coops have been folding in recent months, for a variety of reasons, and now less than half of the 23 original coops are still standing.
“Several co-ops said they wouldn’t be able to enroll new customers in 2016 after the Centers for Medicare and Medicaid Services (CMS) announced that certain reimbursement rates would be only 12.6 percent of what had been expected. Eighteen co-ops were denied money they were expecting, according to Martin Hickey, CEO of New Mexico Health Connections and chairman of the National Alliance of State Health CO-OPs.” Continue reading Health Policy Updates: December 5 2015