Tag Archives: Sarah Kliff

Health Policy Updates: October 22 2017

This week, a bipartisan bill emerged to stabilize the ACA insurance market. It remains unclear whether this compromise proposal will enjoy enough support to pass.

“Alexander said the deal he struck with Murray would extend CSR payments for two years and provide states ‘meaningful flexibility’ under the ACA, allowing them to make changes to insurance offerings as long as the plans had ‘comparable affordability,’ which is a slightly looser definition than the existing one…The framework would also allow insurers to offer catastrophic insurance plans to consumers aged 30 and older on ACA exchanges, while maintaining a single risk pool…”

Sarah Kliff at Vox.com gave the shortest, quickest rundown of the different ACA insurance subsidies, and exactly how the recent Trump executive order would change things:

“The Trump administration is not ending insurance subsidies. Instead, they have created a policy where they spend more money to insure fewer people — something you probably won’t see on the president’s Twitter feed.”

Continue reading Health Policy Updates: October 22 2017

Health Policy Updates: October 15 2017

Vox.com runs down the recent Trump executive order on health care:

“The ultimate impact will depend on any new regulations written as a result of the order, but overall, the Trump administration could make cheaper plans with skimpier benefits more available — and experts worry that will damage the ACA’s marketplaces.”

More on the White House’s efforts to undermine Obamacare in absence of a Congressional repeal bill:

“But Trump administration officials say that with insurance premiums soaring in many states, consumers should be able to buy less comprehensive, less expensive coverage as an alternative to conventional plans…That has some insurance experts worried. The influx of a set of plans exempt from the Affordable Care Act rules will essentially divide the market and make it increasingly unstable, said Rebecca Owen, a health research actuary with the Society of Actuaries.”

The NYTimes is keeping track of all the ways the White House has been sabotaging the health care law.
Continue reading Health Policy Updates: October 15 2017

Health Policy Updates: September 23 2017

The Cassidy-Graham Obamacare repeal bill that is currently under consideration in the Senate would be a big step towards allowing insurance companies to once again exclude people on the basis of pre-existing conditions:

“The bill says states cannot tether an individual’s premiums to ‘sex or membership in a protected class under the Constitution of the United States.’ Anything else — a cancer diagnosis, a history of breast cancer, a mild case of asthma — is fair game. In states that did pursue and receive these waivers, health plans would have full authority to charge sicker patients higher premiums to offset their costs.”
Continue reading Health Policy Updates: September 23 2017

Health Policy Updates: July 16 2017

On Thursday, the Senate released its latest version of its Obamacare-repeal bill, known as the BCRA. Vox.com ran a brief explainer on the key provisions that have changed since prior versions, including a shift towards low-premium (and low-coverage) plans:

“The bill will include a provision based on a proposal by Sen. Ted Cruz (R-TX), which allows health plans to offer skimpy coverage options so long as they have at least one plan that covers a robust set of benefits. The insurance industry opposes the policy, calling it ‘infeasible’ and fearing it would create ‘greater instability.'”

Politico ran a similar outline of the bill’s contents.

The GOP efforts at health care reform, overall, continue to be a “solution in search of a problem.”

“The GOP health care bill doesn’t even have pretextual justifications. Republican leaders like to claim that Trumpcare is necessary because Obamacare is “collapsing” into a “death spiral,” but not only is Trumpcare non-responsive to a death spiral, the death spiral they posit as the basis for Trumpcare is wholly fabricated.”


The supposed urgency behind Obamacare repeal is that it is “collapsing.” This doomsday claim is a bit premature, however, as the exchanges have continued creep along slowly but surely. In fact, a new report out from Kaiser appears to show that the Obamacare insurance exchanges are looking healthier than ever.

“Early results from 2017 suggest the individual market is stabilizing and insurers in this market are regaining profitability. Insurer financial results show no sign of a market collapse…Although individual market enrollees appear on average to be sicker than the market pre-ACA, data on hospitalizations in this market suggest that the risk pool is stable on average and not getting progressively sicker as of early 2017. Some insurers have exited the market in recent years, but others have been successful and expanded their footprints, as would be expected in a competitive marketplace.”


The ongoing challenge for the GOP in passing health care legislation is that different GOP senators have different goals. Some want sustained Medicaid spending, others want even deeper cuts. The NY Times gives a summary of which senators are breaking with the party line to request more changes to the bill – and which senators are pulling in opposite directions.


More great writing on Medicaid by Aaron Carroll and Austin Frakt this week. This time, the topic at hand is the idea that private insurance is inherently “better” insurance than Medicaid. This is one of the chief arguments among Medicaid critics (typically, the GOP) that Americans would be better off by defunding Medicaid and transitioning people to some for of private plans. While it is true that some doctors do not accept Medicaid, causing access problems, in general Medicaid is actually better than private insurance. Medicaid simply pays more of your medical costs; that is, it has lower “cost sharing” requirements – low/no deductibles, copayments, and coinsurance.

And based on well-established research, having low cost sharing is important for the quality of health care that people receive…

“The Senate’s health care plan, for example, would offer much less generous plans. A 64-year-old woman with an income of $11,400 would face a deductible of at least $6,000. For her, such a plan is not better than Medicaid; it is most likely much worse if she is also sick. Because of the deductible, the care she’d need would be financially out of reach.”


Kaiser Health News has recently started a new health policy news podcast called “What the Health.” I just listened to episode #3, a conversation including Margot Sanger-Katz at the NYTimes and Sarah Kliff at Vox.com about the politics behind the BCRA.

I’ll be a new subscriber! Highly recommended.


 

Health Policy Updates: July 1 2017

The CBO report on the Senate’s ACA repeal bill – BCRA – came out on Monday. There are a lot of details, but you can read the general summary here. Since a picture is worth 1,000 words, I think their predictions can best be captured in a single picture – which Alvin Chan and Sarah Kliff at Vox.com have produced from the CBO’s numbers.

CBO projections for uninsurance rates after BCRA passage

If repealing Obamacare was the goal, it looks like BCRA would achieve that. This bill, if it becomes law, would erase all of the insurance coverage gains made over the last 5 years, and effectively take us back to the pre-Obamacare era.

Continue reading Health Policy Updates: July 1 2017