Tag Archives: The Incidental Economist

Health Policy Updates: February 5 2017

With each news story being rapidly overshadowed by the next, discussion of ACA/Obamacare repeal has given way to rapid developments ensuing from executive actions on immigration. If you are a reader of this blog, you certainly do not need me to explain what these actions are. Actions do have unintended (are they unintended?) consequences, however, which I will highlight here (links in the text):

“The American Association for the Advancement of Science, the world’s largest general science society, also issued a statement warning that the ban would prevent the international collaboration that characterizes most science today, and would hurt the United States’ ability to attract talented researchers from around the world.”

As the story of a Cleveland Clinic doctor forced to leave the U.S. thanks to the Trump White House’s move swept the nation, hospitals and academic medical centers braced for potential damage to future staffing and recruiting of medical researchers, educators and clinicians.”

“Since the restrictions, some institutions, including the University of Pennsylvania and the University of California system, have advised students or faculty members from Iran, Iraq and the other affected countries not to travel overseas until further notice…The order could prevent many foreign researchers from making short-term trips to attend conferences and other scientific meetings overseas for fear of not being able to return.”

Continue reading Health Policy Updates: February 5 2017

Health Policy Updates: November 26 2016

It is important to remember that rising insurance costs are not a phenomenon limited to the Obamacare exchange plans. Health care costs continue to rise overall, and insurance companies have to charge higher premiums and copays to keep up. Employment-based health insurance plans will be costing 5.5% more, and employee out-of-pocket costs continue to increase even faster and have now nearly doubled since 2009.

A recent study in JAMA Oncology highlighted an important point regarding the “financial toxicity” of cancer care – having Medicare coverage is often not enough to protect from catastrophic costs. 10% of Medicare patients with a new diagnosis of cancer will spend two-thirds of their annual income on health care bills.

“Beyond highlighting the need for innovative initiatives for delivery of care, the high level of hospital-associated OOP costs may also demonstrate potential adverse consequences of Medicare’s current design of benefits…Assigning beneficiaries such a high responsibility of cost sharing for inpatient care may not be an effective use of cost sharing, as hospitalizations are usually not at the discretion of beneficiaries.”

A conversation on the potential for Obamacare repeal, from The Incidental Economist bloggers Aaron Carroll and Austin Frakt.

“They’re actually in a tough policy spot. They’ll get the blame if they don’t fix or repeal the A.C.A., and they’ll get the blame if they don’t replace it with something people like better. Health policy is a very difficult and thankless task. I think they’ll opt for something they can call repeal and replace, but they could also just let Obamacare struggle and die. Neither looks good.”

In order to convince health insurance companies to engage in the ACA/Obamacare exchanges, the law included a provision known as the “risk corridors.” In sort, if insurance companies ended up losing money because they insured sicker-than-average patients who incurred higher-than-average health care costs, the risk corridor system would give them money to recoup the losses. So, insurance companies joined the ACA exchanges. And they dutifully lost money. However, Congress did not appropriate money for the risk corridors, so these insurers are still short billions of dollars that was promised to them, and are suing the government to get it.

Nicholas Bagley reports on the debacle at the NEJM.

“For now, the Justice Department is fighting the lawsuits. But the insurers’ legal arguments have considerable force. Indeed, HHS has openly acknowledged that risk-corridor payments are ‘obligation[s] of the United States for which full payment is required.'”

Surgeon General Murthy on ending the opioid epidemic.

Health Policy Updates: November 19 2016

Soon after the election, Donald Trump is already backpedaling from his prior promises to repeal the ACA/Obamacare in its entirety, signaling that he may be open to keeping several of the popular aspects of the law. The problem? The unpopular parts he wants to get rid of aren’t there for no reason – they are needed to make the popular parts work.

“The pre-existing conditions policies are very popular…Those policies that make the insurance market feel fairer for sick Americans who need it can really throw off the prices for everyone else. That’s why Obamacare also includes less popular policies designed to balance the market with enough young, healthy people.”

Continue reading Health Policy Updates: November 19 2016

Health Policy Updates: May 14 2016

It was deja vu all over again, when a federal court judge laid down a ruling that (if it ultimately stands) would be a severe blow to the ACA/Obamacare.

What was the legal question this time? Apparently, the ACA cannot spend money to subsidize health insurance (all of the reduced-price insurance plans on the health care exchanges) without first having appropriated the money through Congress. Read more, from Sarah Kliff at Vox, here.

“This victory in Washington isn’t the final word on the lawsuit. But it does allow it to move forward, and means that the legal battle over Obamacare — one that has already included four Supreme Court cases — still isn’t over yet.”

Hillary Clinton made the health policy news this week for new statements regarding her ideas for new health care legislation. In contrast to Bernie Sanders’ “Medicare for All” single-payer type of plan, her new proposal for expanding health insurance coverage is being characterized as “Medicare for More.”

“The Medicare program covers Americans once they reach 65. Beneficiaries pay premiums to help cover the cost of their coverage, but the government pays the bulk of the bill. Mrs. Clinton’s suggestion was that perhaps younger Americans, ‘people 55 or 50 and up,’ could voluntarily pay to join the program.” Continue reading Health Policy Updates: May 14 2016

Health Policy Updates: January 22 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